• Journal of The Korean Society of Integrative Medicine
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• v.7 no.1
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• pp.81-88
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• 2019

Purpose : The purpose of this study was to examine if there is any correlation between pelvic tilt angle and trunk motion and trunk extensor during trunk forward flexion and to measure trunk motion, onset time of trunk motion, and onset time of trunk extensor activation. Methods : The subjects of this study were 42 healthy adults. The subjects had no back pain due to neurological disease and no experience of back surgery. After pelvic tilt angle was measured, each trunk forward flexion was performed three times. Trunk motion and onset time of trunk motion were measured using Myomotion. Four sensors were used, with one located at the upper thoracic (below $C_7$), the lower thoracic ($T_{12}-L_1$), the sacrum ($S_1$), and at the center of the anterior femur. Onset time of trunk extensors (spinalis, longissimus, gluteus medius, gluteus maximus, biceps femoris, and gastrocnemius) activation was measured using a wireless surface EMG. The EMG amplitude was normalized by using the reference voluntary contraction (RVC). The statistical significance of the results were evaluated using Pearson's correlation test. Results : The correlation between pelvic tilt angle and lumbar motion, onset time of pelvis motion, and onset time of gluteus medius activation was statistically significant in a positive direction (p<.05). The correlation between pelvic tilt angle with pelvis motion, onset time of lumbar motion, and onset time of longissimus activation showed a statistically significant negative correlation (p<.05). Conclusion : The study results provide a significant contribution to our understanding of the lumbar load at the initial stage of trunk flexion. Therefore, it may be possible to provide basic data for evaluation and treatment, such as orthodontic treatment for alignment of the spine and back pain. In addition, it is necessary to focus on normal exercise pattern reeducation as well as pelvic correction during exercise in daily life or in industrial fields.

• Journal of the Ergonomics Society of Korea
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• v.33 no.2
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• pp.143-153
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• 2014

Objective: The aim of this study is to investigate the effects of trunk-forearm supported sitting on trunk flexion angle, trunk extensor fatigue and seat contact pressure. Background: The relationship between sitting posture and musculoskeletal disorders of the trunk extensor fatigue and seat contact pressure has been documented. The trunk-forearm support type ergonomic chair was devised from the fact that trunk-forearm support has been reported to reduce trunk extensor activity and discomfort. Method: Using three different sitting postures, upright ($P_1$), trunk-forearm supported ($P_2$) and normal sitting ($P_3$), six healthy subjects participated in the study. Motion capture system was used to collect head and trunk flexion angle, and surface electromyography (sEMG) was used to collect myoelectric signal of upper trapezius, lower trapezius, erector spinae, multifidus, and pressure mat system was used to measure seat contact pressure. Results: When trunk and forearm were supported by the ergonomic chair, higher head flexion angle showed upright > trunk-forearm supported > normal in order, and muscle fatigue showed less than upright and normal sitting. Mean seat contact pressure decreased 19% than upright sitting. But muscle fatigue was not affected by each condition. Conclusion: Trunk-forearm supported sitting of the ergonomic chair showed positive effect in respect of trunk and head flexion angle, trunk extensor fatigue, seat contact pressure. To acquire comprehensive understanding of the effectiveness of the ergonomic chair, further studies such as anatomical effects from measurement of external applied loading effect to the body from interface pressure analysis are required. Application: The results of the publishing trend analysis might help physiological effects of trunk-forearm support type chair.

• Physical Therapy Korea
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• v.27 no.3
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• pp.171-177
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• 2020

Background: The flexion-relaxation phenomenon (FRP) refers to a sudden onset of activity in the erector spinae muscles that recedes or fades during full forward flexion of the trunk. Lumbar spine and hip flexion are associated with many daily physical activities that also impact trunk flexion. Shorter hamstring muscles result in a reduction of pelvic mobility that eventually culminates in low back pain (LBP). Many studies have explored the FRP in relation to LBP. However, few studies have investigated the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Objects: This study aimed to investigate the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Methods: Thirty subjects were divided into three groups according to hamstring length measured through an active knee extension test. The 30 participants consisted of 10 subjects who had a popliteal angle of 20° or less (Group 1), 10 subjects who had a popliteal angle of 21°-39° (Group 2), and 10 subjects who had a popliteal angle of 40° or more (Group 3). A one-way analysis of variance was used to compare the difference in muscle activity of the erector spinae muscles during trunk flexion. Results: The subjects with a shorter hamstring length had significantly higher muscle activity in their erector spinae muscles during trunk flexion and full trunk flexion (p < 0.05). The subjects with a shorter hamstring length also had a significantly higher flexion-relaxation ratio (p < 0.05). Conclusion: The results of this study demonstrate that differences in hamstring muscle length can influence the FRP in relation to the erector spinae muscles. This finding suggests that the shortening of the hamstring might be associated with LBP.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.2
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• pp.1-15
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• 2008

Purpose : This survey was to investigate on the effect of each region changed in trunk through sagittal plane after Trunk Flexion-Extension Exercise. Methods : 18 students of Gimcheon College participated in this study for the period of July 9-30, 2007. Analyzed factor were 1) degree of pain 2) presence of Gillet test and 3) difference of right-left for 7 landmark region in trunk applying I.B.S.-2000 after Trunk Flexion - Extension Exercise. We used the SPSS $PC^+$ program for classifying into analysis of frequency, $x^2$-test, t-test and Simple Linear Regression analysis test. Results: Followings are concluded For degree of pain, 13(72.2%) of students answered "No pain" after Trunk Flexion-Extension Exercise and in the result 4 more students decreased the pain. In the Gillet test, 14(77.8%) of students answered "positive" after Trunk Flexion-Extension Exercise and in the result 4 more students increased mobility of Sacroiliac joint. In the differences of right-left for 7 landmark region in trunk by B.M.I. scale, Slim type was decreased both Acromion(0.45mm), both Iliac crest(0.44mm), and both ASIS(0.31mm) to anterior plane, Normal type was decreased both inferior angle of Scapular(0.02mm), both L4-5(0.07mm), and both PSIS(0.09mm) to posterior plane Fatness type was decrease both Acromion(0.05mm), both ASIS(0.05mm) to anterior plane. In the differences of right-left for 7 landmark region in trunk for degree of pain No pain group was decreased both Acromion(0.17mm), both Nipple(0.25mm) to anterior plane and both PSIS(0.13mm) to posterior plane Pain group was decreased both Acromion(0.04mm), both Iliac creast(0.03mm) to anterior plane and both inferior angle of Scapular(0.18mm) both PSIS(0.13mm) to posterior plane. In the difference of right-left for 7 landmark region in trunk for each of the exercises, Both iliac crest(0.1mm), both ASIS(0.12mm) to anterior plane were decreased after Flexion Trunk Exercise. Both acromion(0.27mm) to anterior plane, both inferior angle of scapular(0.14mm) and both PSIS(0.12mm) to posterior plane were decreased after Extension Trunk Exercise. Each of the exercises, The both inferior angle of Scapular showed high scores($0.65{\pm}0.23$) at Trunk Extension Exercise group and there was statistical significance between Trunk Flexion Exercise group and Extension exercise group(t :-2.502, p < 0.05). 7. At Pre-exercise group, Both inferior angle of Scapular showed low scores($0.23{\pm}8.27$) at Trunk Extension Exercise group and there was statistical significance between Pre- Exercise group and Trunk Extension Exercise group(t :-2.5430, p<0.05). Conclusion : The simple linear regression analysis was presented at Acromion(-0.243), L4-5(-0.753), PSIS(0.576) and there was statistical significance in BMI scale(p<0.01).

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1066-1070
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• 2016

The purpose of this article was to investigate the effects of Maitland's transverse movement on change of pain, trunk flexion movement and Cobb's angle in patient with upper thoracic scoliosis. The subject are 37 years old with chronic low back pain participated in this study and has no experience surgery within the last six months due to back pain. 10 set was applied 10 times on the T3-T5 applied the transverse movement with grade IV to each segment by skilled physical therapist. Transverse movement was applied convex toward the concave side. Pressure pain threshold was reduced from 4/10 to 2/10. Trunk flexion range that is the distance between the middle finger and floor was increase from 7.3cm to 2cm. Cobb's angle was decreased from degree 18 to 16. This result demonstrated that the Maitland's transverse movement was benefit to reduce the pain and Cobb's angle, and to increase the trunk flexion movement.

• PNF and Movement
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• v.9 no.3
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• pp.11-17
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• 2011

Purpose : The purpose of this study was to analyze the effects of proprioceptive neuromuscular facilitation (PNF) leg flexion patterns according to the hip joint angle on electromyographic activity of the trunk. Methods : Thirty healthy adults volunteered to participate in this study. Subjects were required to complete following the PNF leg flexion patterns on three different hip joint flexion $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$. An surface electromyogram (SEMG) was used to record the electromyographic activities of the trunk muscle in rectus abdominis, internal oblique abdominal, external oblique abdominal, erector spinae. The data were analyzed using the a repeated measures of one-way ANOVA with post-hoc Bonferroni's correction. Result : The results of this study are summarized as follows: The EMG activities of internal abdominal oblique and elector spinae muscle showed a statistically significant difference (p<.05). Conclusion : The result show that electromyographic activity of the trunk muscles significantly changed on PNF leg flexion patterns with difference hip joint angle. Therefore, this study used to basis for the intervention of the trunk muscle strength and stabilization.

• Journal of the Ergonomics Society of Korea
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• v.30 no.5
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• pp.637-644
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• 2011

Objective & Background: When applying various evaluation tools that analyze work posture risk through observation, accurate measurement of body flexion angle is very important. Method: This study investigated differences and appropriateness of 5 different existing reference points commonly used in the analysis of the work posture. Twenty five ergonomist and trained professionals were participated in this study. A Same flexion angle was utilized for the evaluation of risk assessment of musculoskeletal disorders using five different reference points to investigate the degree of difference between them. To investigate how different the observers' preferred flexion angle measuring methods were compared to the ISO 11226 Reference Posture, a virtual body model was constructed using the Poser 6.0 program. Six types of body flexion postures were constructed, and since neck flexion differs according to body angle, five types of neck flexion postures were constructed with the trunk bending $20^{\circ}$ forward, making up a total of 30 virtual flexion postures. Results: Results showed that the observers used personally preferred reference points instead of reference points recommend in the evaluation tools. Also the results revealed the their seems to be 6 types of flexion angle for the trunk and 11 types of measurement methods for the neck flexion angle in the form of personally preferred reference points. The results showed that a mean difference of $14^{\circ}$($4{\sim}23^{\circ}$) occurred in the trunk, and a mean difference of $20^{\circ}$($-8{\sim}51^{\circ}$) occurred in the neck. To increase accuracy when using the 5 evaluation tools in combination, the ISO 11226 standards, observers' preferred flexion posture standards, and common flexion posture standards of the evaluation tools were compared with the reference points of the 5 evaluation tools. Results showed considerable variance in angle difference for each evaluation tool. Conclusion: According to the results of this study, considering the angle difference between the flexion angle reference points of the evaluation tool and the reference points selected by the observers, it is concluded that instead of personally preferred reference points, the standardized reference points to enhance the accuracy and the objectivity. Application: The result of this study can be used as reference guide to develop the standardized reference point in the future.

• Physical Therapy Korea
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• v.18 no.1
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• pp.57-63
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• 2011

The purpose of this study was to identify the effects of manual facilitation and a stick on lumbar and hip joint flexion angles in subject with lumbar flexion syndrome during forward bending from a sitting position. Fifteen subjects with lumbar flexion syndrome were recruited for this study. As a pretest, all subjects performed three repetitions of bending the trunk forward until the tips of their fingers touched the target bar. After this pretest, the subjects practiced the forward bending of the trunk 10 times, using either manual facilitation or a stick. Then, as a posttest, all subjects repeated the pretest procedure. The flexion angles of lumbar spine and hip joint during forward bending in a sitting position were measured using a three-dimensional motion analysis system. A paired t-test was used to determine the statistical differences between pre-test and post-test flexion angles and pre- and post-test flexion angle differences between forward bending with manual facilitation and forward bending with a stick. The level of statistical significance was set at p=.05. The results of the study showed that the angle of the lumbar flexion decreased significantly and the bilateral hip flexion angle increased significantly when performing forward bending with stick and manual facilitation. Furthermore, the angle of lumbar flexion decreased significantly and the angle of bilateral hip flexion increased significantly in forward bending with a stick compared to forward bending with manual facilitation. The findings of this study indicate that both forward bending with manual facilitation and sticks could be used to prevent excessive lumbar flexion and increase hip flexion, and that forward bending with a stick is more effective than forward bending with manual facilitation for inducing lumbar spine and hip joint angle changes.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.277-282
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• 2011

When we keep sitting for a long time, we end up with pain due to changes in the curvature in the waist. This study examined impacts from the wearing of a SPINE-GUARD(belt for the waist stabilization) on a cross-legged sit on variations of the Cobb's angle, lower back pain and trunk flexion angle. 15 men for the examination have watched movies or attended lectures while wearing a belt for 90 minutes per round for every five rounds for two weeks. The Cobb's angle showed a significant decrease from $48.36{\pm}14.57$ before wearing to $28.09{\pm}11.63$ after wearing (p<0.05). Pain decreased from $4.53{\pm}2.36$ before wearing to $2.733{\pm}2.153$ after wearing (p<0.05). The trunk flexion angle also showed a significant decrease from $82.33{\pm}20.30$ before wearing to $70.2{\pm}19.43$ after wearing (p<0.05). Given these findings, the wearing of a SPINE-GUARD seems to affect variations of the Cobb's angle and trunk flexion angle, and decrease of lower back pain.

• Journal of Korean Physical Therapy Science
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• v.26 no.2
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• pp.61-73
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• 2019

Purpose: This study was to evaluate the effect of cranio-cervical flexion based trunk stabilization exercise on gross motor function and posture alignment change in children with spastic cerebral palsy. Design: Randomized Controlled Trial. Methods: Twenty-six children participated in this study. All subjects were randomly assigned to either the Cranio-Cervical Flexion Based Trunk Stabilization Exercise (CCFTS) group (n=13) or the Trunk Stabilization Exercise (TS) group (n=13). In both groups were trained general physical therapy for 10 minutes, in the CCFTS group was trained cranio-cervical flexion based trunk stabilization exercise for 20 minutes and in the TS group was trained trunk stabilization exercise for 20 minutes. The training was provided 2 times a week during 8 weeks. All subjects were measured with the Gross Motor Function Measure (GMFM) and Cranio-Vertebral Angle (CVA) before and after intervention. Results: The results showed that the CCFTS have increased significantly in GMFM (B, C, D and E-dimension) and CVA, and the TS group have increased significantly in GMFM (B, C D and E-dimension). In particular, the CCFTS group improved significantly than TS group in GMFM (B, C and D-dimension) and CVA. Therefore, the cranio-cervical flexion based trunk stabilization exercise improved gross motor function and posture alignment in children with spastic cerebral palsy. Conclusion: These results suggest that cranio-cervical flexion based trunk stabilization exercise is feasible and suitable for individuals with a spastic cerebral palsy and can be used in addition to conventional physical therapy.