• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.68-73
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• 2004

Transverse rectus abdominis muscle (TRAM) free flap is widely used for breast reconstruction, however donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. For the purpose of minimizing donor-site morbidity, there has been a surge in interests in muscle sparing free TRAM flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. The purpose of this study is to investigate complication and morbidity after muscle sparing free TRAM flap. Between August, 1995 and May, 2003, there were 108 cases of muscle sparing free TRAM flap of breast reconstruction. There was no abdominal hernia. There were 4 cases of dog ear, 3 cases of marginal necrosis of apron flap, 2 cases of asymmetry of umbilicus. At 1 year after operation, most patients feel comfortness in physical exercise. Muscle sparing free TRAM flap provides ample amount of well vascularized soft tissue with small inclusion of rectus abdominis muscle and fascia. Also it minimizes donor-site morbidity with rapid recovery of abdominal strength.

• 한국운동역학회지
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• 제20권4호
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• pp.415-420
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• 2010

The purpose of this study was to compare the thickness of the abdominal muscles during single leg holding exercise (SLH) in a hooked lying position on stable surface and on a foam roller. Healthy twenty subjects who had no medical history of lower extremity or lower back pain were recruited for this study. Muscle thickness of transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) was recorded using real-time ultrasonography during SLH. Paired t-test with Bonferroni adjustment was used to compare the muscles thickness during SLH on stable surface and on a foam roller. The result showed that TrA and IO muscle demonstrated greater thickness during SLH on foam roller than those on the stable surface. This finding suggests that SLH on an unstable foam roller is more effective to increase thicknesses of TrA and IO muscles than stable surface.

• 대한물리치료과학회지
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• 제30권3호
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• pp.31-40
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• 2023

Background: The purpose of this study was to confirm the effect of bridge exercise combined with vibration on abdominal muscle thickness. Design: Randomized controlled trial. Methods: As study subjects, 24 adults in their 20s were classified into 12 vibration bridge exercise groups and 12 bridge exercise groups. The time was divided into before the experiment, 3 weeks after the experiment, and 6 weeks after the experiment. Two-way repeated ANOVA was used to examine changes in the muscle thickness of the external oblique, internal oblique, and transverse abdominal muscles of the trunk muscles, and the significance level was set at 0.05. If there was an interaction between time and group, post-hoc analysis was performed, and the significance level was set at 0.01. Results: There was a significant difference in the external oblique muscle in the change by period, the interaction between time and group, and the change between groups (p<0.05). There was a significant difference in the external oblique muscle in the change by period, the interaction between time and group, and the change between groups (p<0.05). Conclusion: As a result of this study, bridge exercise combined with vibration had a positive effect on the muscle thickness of the external oblique, internal oblique, and transversus abdominis muscles. It suggests the possibility of using the basic data of vibration exercise and the lumbar stabilization exercise in clinical practice.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.1-7
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• 2014

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.

• 대한통합의학회지
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• 제8권1호
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• pp.67-76
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• 2020

Purpose : The purpose of this study was to provide more effective interventions for elderly men with weak core muscles by measuring the thickness of the muscles according to the five core stabilization exercise and comparing the thickness differences in muscles in each posture. Methods : The study selected 29 elderly men aged 65 to 80 years old among outpatient patients at S Medical Center in B city, and measured the muscle thickness by exercise posture once. In order to find out the thickness of the external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) muscles were measured by using rehabilitative ultrasound imaging (RUSI) in five exercise conditions. Results : A significant change in the thickness of the EO muscles in each group was measured by the method of motion, followed by the abdominal crunches (1.67±0.15), the lower body rotations (1.54±0.07). As a result of measuring the thickness of the IO muscles of each group according to the exercise method, the bridge group (1.14±0.22) was the highest, followed by the abdominal drawing group (1.05±0.03). As a result of measuring the thickness of the TrA muscles of each group according to the exercise method, the abdominal crunches (0.98±1.00) were the highest, and the bridge group (0.57±0.05) were higher in order of magnitude. Conclusion : Consequently, the five core stabilization exercises all affect changes in abdominal thickness and are expected to continue to require training studies on muscle posture.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.542-547
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• 2014

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.

• Archives of Reconstructive Microsurgery
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• 제22권1호
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• pp.7-12
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• 2013

Purpose: Breast reconstruction with lower abdominal tissue can produce the best outcome with acceptable rates of long-term complication. However, for cases in which sufficient abdominal tissue is not available, an superior gluteal artery perforator (SGAP) flap can be considered as the next option for autologous breast reconstruction. Materials and Methods: Among a total of 63 women who underwent breast reconstruction with free autologous tissue transfer from July 2010 to April 2011, SGAP flap was performed for four patients. In two cases, patients did not have enough abdominal tissue for sizable breast reconstruction. In another case, the patient had a long abdominal scar due to donor hepatectomy of liver transplantation. In the last case, which was a revisional case after radiation necrosis of a previous pedicled transverse rectus abdominis musculocutaneous (TRAM) flap, a large amount of healthy skin and soft tissue was needed. SGAP flap was elevated in lateral decubitus position. The internal mammary vessels were used for recipient vessels in all cases. Results: Breast reconstruction was performed successfully in all four cases without flap loss. Donor site complication was not observed, except for one case of seroma. The shape of the reconstructed breast was satisfactory in all patients. Conclusion: SGAP flap is an excellent alternative option for the TRAM or deep inferior epigastric artery perforator flap for breast reconstruction. In terms of narrower width, harder consistency of soft tissue, and shorter pedicle, it is clear that the SGAP flap is less competent than the TRAM flap. However, in cases where abdominal tissue is not available, SGAP flap is the only way of providing a large amount of healthy tissue.

• 대한통합의학회지
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• 제9권1호
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• pp.1-11
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• 2021

Purpose : The purpose of this study was to investigate the effect of single limb stance exercise according to the support surface on dynamic balance ability and abdominal muscle thickness. Methods : We recruited 28 healthy subjects in this study. Subjects were assigned to 2 groups by matching method. The control group was 5 males and 9 females, and single limb stance exercise was performed on the stable support surface. The experimental group consisted of 6 males and 8 females, and trained to stand on the unstable support. During the single limb stance exercise, the dominant foot was set as the foot that appeared numerically through the exercise of the dynamic balance meter (Biorescue). Single limb stance exercise along the supporting surface was maintained for 15 seconds and then rested for 15 seconds. It was repeated 5 times. Particularly, the balance exercise on the unstable support surface was sufficiently practiced. Independent t test was performed for comparison between groups. Paired t test was performed to compare before and after each group. Results : There was no difference between the control group and the experimental group in the comparison of dynamic balance ability (p>.05). However, there were significant differences before and after exercise in both the control and experimental groups (p<.05). Similarly, in the comparison of abdominal muscle thickness, there was a significant difference within each group, especially internal oblique and transverse abdominis (p<.05), and no difference between groups (p>.05). Conclusion : Based on these results, although there was no difference between the groups, in the experimental group, numerical increase in dynamic balance ability and abdominal muscle thickness was confirmed. Therefore, single limb stance exercise on the unstable support surfaces activates core muscles and has a positive effect on dynamic balancing ability.

• 대한통합의학회지
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• 제10권1호
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• pp.81-89
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• 2022

Purpose : Kegel exercises reported that it is effective in managing stress-related or complex urinary incontinence through contraction and relaxation of the pelvic floor muscles. In many previous studies, it was confirmed that Kegel exercise is involved in respiration as well as urinary system diseases. However, there is a lack of research on the effect of pelvic setting when performing Kegel exercises. Therefore, this study was conducted to investigate the effect on maximum voluntary ventilation (MVV) and abdominal muscle thickness through Kegel exercise after lumbar-pelvic motor control using pressure biofeedback unit (PBU). Methods : The subjects of this study were 10 healthy female students in their 20s. Subjects measured MVV with a spirometer. In hooklying, external oblique, internal oblique, and transverse abdominis of the dominant hand were measured using ultrasound. The measured value was an average of three times. After one week of intervention, measurements were made in the same manner. Before Kegel exercise, pelvic setting training was performed using PBU. In hooklying, PBU was placed in the waist and set to 40 mmHg, and it was adjusted to 60 mmHg through pelvic muscle contraction. For Kegel exercise, the pelvis was first set using PBU, and then the pelvic floor muscles were contracted for 8 seconds and relaxed for 8 seconds, 10 times, 1 set, and 3 sets. Results : In MVV, a significant difference was confirmed after exercise than before exercise (p<.05). There was also a significant difference in abdominal muscle thickness before and after exercise (p<.05). Conclusion : Based on the results of this study, Kegel exercise using PBU had an effect on MVV and abdominal muscle thickness. However, since this study was conducted without a control group as a preliminary study, additional research should be conducted to supplement this.

• 재활복지공학회논문지
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• 제11권3호
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• pp.207-214
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• 2017

몸통안정성에 문제가 발생하면 허리에 통증이 발생된다. 허리 불안정성을 해소하기 위한 몸통안정화운동 방법 중 하나인 복부드로우인기법(ADIM)은 복부안정화근육 중 선행적자세조절과 관련된 배가로근에 대한 선택적인 수축을 유도하는 운동법이다. ADIM은 일반적으로 바로누운자세에서 허리 밑에 압력생체되먹임장치(PBU)을 적용하여 시각적되먹임을 한 상태에서 실시하는데 이러한 자세는 앉은자세에 비해 기능적이지 못하다. 본 연구에서는 바로누운자세와 앉은자세에서 실시하는 ADIM의 효과를 알아보기 위해 31명의 건강한 남녀를 대상으로 무선 근전도를 이용해 배곧은근(RA), 배바깥빗근(EO), 배가로근/배속빗근(TrA/IO), 그리고 척추세움근(ES)에 대한 근활성도를 비교하였다. 본 연구 결과 RA와 EO에서는 두 자세 간에 유의한 차이가 없었으며 TrA/IO와 ES에서는 두 자세 간에 유의한 차이가 나타났다. 또 RA에 비해 TrA/IO의 활성도가 높게 나타나 ADIM로 인한 몸통안정화는 두 자세 모두에서 효과적으로 나타났으며 반면 TrA/IO와 ES는 앉은 자세에서 더 높은 활성도를 보여 자세 안정화 근육의 활성도가 앉은 자세에서 더 증가한 것으로 사료된다. 따라서 일상생활에서 보다 쉽게 적용할 수 있는 앉은 자세의 ADIM은 허리안정성 향상에 유용할 것이다.