• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• 대한물리치료과학회지
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• 제16권1호
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• pp.11-20
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• 2009

Background: The purpose of this study was to investigate the effect of stretching and strengthening exercise on the static flexibility and pain intensity for the iliopsoas muscle, which is one of the main reasons for the chronic low back pain. Methods: The subjects of this study were 15 male adult patients with showed 6 score or higher in the visual analogue scale(VAS) and complained of low back pain over three months who visited department of the physical therapy, KIA motors Industrial Health Center, from October, 2008 through December, 2008. Fifteen subjects were trained stretching, mat exercises and sling exercises for iliopsoas muscle at 4-5 times a week for 4 weeks. I measured the changes on the extensibility of iliopsoas muscle, static flexibility of low back and VAS between pre- and post exercise treatment. Date were analyzed using the Wilcoxon's signed rank test considering the size of the samples. Results: 1. The angle of the hip joint that showed the extensibility of iliopsoas muscle was relieved, which was significant statistically (p<.05). 2. The static flexibility was statistically significantly improved in the trunk flexion test, trunk extension test and Schober-Test (p<.05). 3. The VAS showed decrease, which is significant statistically (p<.05). Conclusion: It is believed that the exercise treatment of iliopsoas muscle has the significant effects on the improvement of static flexibility and decrease of pain intensity for the chronic low back pain patients.

• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.37-48
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• 2005

Objects: This study is designed to analysis improvement and maintaince of trunk stability targeting patients who need post operative rehabilitation exercise after undergoing opened microscopic laser discectomy(OMLD) due to HNP. Method: Between March 2004 and February 2005 a total sixty patients who underwent OMLD due to $L_4/L_5$, $L_5/S_1$ HNP and who agreed to the experiment were subject for this study. Experimental group consisted of 18 subjects, and they underwent 45 minutes dynamic lumbar stabilization exercise And control group consisted of 18 subjects who conducted conservative physical therapy based on the use of physical modality for 45 minutes except to exercise. Results: Experimental group that was lumbar extensor's isometric peak torque, weight distribution of both leg, trunk muscle balance and Oswestry LBP disability index increased during 12 weeks in a statistically significant manner compared to before exercise (p<.05). When re-test was tried, isometric peak torque (p>.05) and Oswestry LBP disability index(p<.05) maintained 12th week level or improved. Weight distribution rate of both leg and trunk muscle balance maintained the level of 8th week of exercise execution(p<.05). Control group that was lumbar extensor's isometric peak torque, weight distribution rate of both leg and trunk muscle balance aggravated during 12 weeks compared to pre-test(p>.05) But, Oswestry LBP disability index increased in a statistically significant level compared to pre-test(p<.05). When re-test was tried, isometric peak torque increased slightly compared to pre-test, but decreased when at least $60^{\circ}$ flexion angle(p>.05). Weight distribution rate of both leg and trunk muscle balance also aggravated compared to pre-test(p>.05), and Oswestry LBP disability index was similar to the 4th week of physical therapy execution(p>.05). Conclusion: Successive postoperative Especially, Application of dynamic lumbar stabilization exercise program is important than traditional lumbar strengthening exercise program in the maintaince of spinal stability.

• 대한물리의학회지
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• 제13권3호
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• pp.39-47
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• 2018

PURPOSE: The purpose of this investigation was to conduct a systemic review of studies that examine the effects of strengthening exercise on gait ability and GMFM in children with cerebral palsy and propose a standard for cerebral palsy therapy based on a meta-analysis of the studies. METHODS: An extensive literature search was conducted using databases including the KISS (Korean studies Information Service System), RISS, DBpia, PubMed and ScienceDirect, with the following search terms: 'Strengthening Exercise,' 'Resistance Exercise,' 'Gait ability,' 'GMFM' or 'cerebral palsy'. RESULTS: Eleven studies were included in this review and the duration of the intervention varied from 5 to 24 weeks. The number of application per week was mostly 2-3 times, while 5 intervention per week was adopted in a few cases. The total number of intervention applied varied from 18 to 36 and the respective effect sizes of GMFM on crawling and sitting were very high (1.075 and .881) while those of GMFM on standing and walking were very low(.206 and .125). The effect size was for gait speed was only .221. CONCLUSION: Trunk exercise and lower limb exercise effectively improved GMFM in children with cerebral palsy, resulting in improved outcomes in sitting and crawling. The results of this study will be useful for designing evidencebased cerebral palsy therapy programs.

• 대한통합의학회지
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• 제4권4호
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• pp.101-108
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• 2016

Purpose : The purpose of this study was to determine the effect of selective thoracic extensor strengthening exercises in the sitting position using a foam-roller by investigating the electromyographic(EMG) activities of the thoracic and lumbar extensors. Methods : Eighteen healthy subjects with no medical history of back pain were recruited. EMG activity was recorded from thoracic extensor(TE) and lumbar extensor(LE) while subjects performed three thoracic extension exercises: prone thoracic extension(PTE), prone thoracic extension with abdominal draw-in maneuver(PTE-ADIM), and sitting thoracic extension using a foam-roller(STE). TE and LE EMG activity, and TE/LE EMG activity ratio were analyzed by one-way repeated-measures analysis of variance(ANOVA). Where a significant difference was identified, a Bonferroni correction was performed(p<.017, .05/3). Results : TE and LE EMG activity, and TE/LE EMG activity ratio differed significantly among the three exercises(p<.05). Post hoc pair-wise comparison with Bonferroni correction showed that TE muscle activity in the STE exercise was significantly different from PTE and PTE-ADIM exercises(p<.017). There was no significant difference between TE muscle activity for PTE and PTE-ADIM exercises(p>.017). LE muscle activity and TE/LE ratios were significantly different among the three exercises p<.017). Conclusion : TE/LE ratio showed superior selective thoracic extensor strengthening for the STE exercise than PTE and PTE-ADIM exercises. Therefore, we recommend STE exercise for selective thoracic extensor strengthening.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.28-36
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• 2011

The aim of this study was to compare electromyography activity for long and lateral heads of triceps brachii muscle according to forearm positions during different triceps strengthening exercises. The muscle activities for long and lateral head of triceps brachii were measured by surface electromyography. Fifteen healthy volunteers participated for this study and performed elbow extension in three different elbow extension exercises (elbow extension in a supine position; EES, elbow extension with shoulder abduction at 90 degrees in a prone position; EESA, and elbow extension with one arm at the side of the trunk in a prone position; EESP) and forearm positions (supination, neutral, and pronation). A two-way repeated measures ANOVA was used to compare the effects of the exercise positions and forearm positions. The EMG activities of the long head of the triceps brachii increased significantly during EESP with forearm supination, whereas the activity of the lateral head of the triceps brachii increased significantly during EESA with the forearm in a neutral position (p<.05). The results of this study suggest that exercise positions and forearm positions should be considered for selectively strengthening the long and lateral heads of triceps brachii muscles.

• 대한물리의학회지
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• 제11권3호
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• pp.59-63
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• 2016

PURPOSE: The purpose of the present study is to examine the effects of sole Pilates based breathing on the thicknesses of the abdominal muscles. METHODS: Twenty adults aged in their 20-30s were randomly selected. The selection criteria were those who had no medical history of pain due to musculoskeletal system, neurologic, or orthopedic diseases within six months before the selection. The thicknesses of the abdominal muscles (the transversus abdominis muscle, internal oblique abdominal muscle, and external oblique abdominal muscle) of the subjects were measured using ultrasonography before and after Pilates breathing. The study was approved by the research ethics committee of the Catholic University of Pusan. RESULTS: After Pilates based breathing, the thicknesses of the transversus abdominis muscle, the internal oblique abdominal muscle, and the external oblique abdominal muscle increased significantly. In particular, the thickness increase rate of the transversus abdominis muscle was shown to be the highest. CONCLUSION: Sole Pilates based breathing is expected to be effective for the improvement of trunk stability through strengthening of abdominal muscles, because it induces the coordinated contraction of the transversus abdominis muscle and other abdominal muscle. It will be need the Longitudinal study for identify to long term effects of Pilates based breathing.

• 한국운동역학회지
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• 제21권3호
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• pp.281-288
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• 2011

The purpose of this study was to analyze the difference in reaction patterns during the support phase after perturbation in gait according to different age. A total of 12 subjects participated; 5 elderly and 7 adults(control), to investigate the differences between normal and perturbed gait. The step length didn't change during normal and perturbed gait but was longer in the control group. There was no difference in the step width. When the right foot was perturbed, the control group's left foot speed was faster than the elderly group's which was to maintain stability. The elderly flexed both right and left knees more than the control group. After the perturbation, the elderly group had a larger trunk anterior flexion. With the larger flexion of both legs of the elderly group it shows that the lack of knee flexion strength is a factor, that could cause falling and so a prevention program should focus on strengthening the quadriceps. With the excessive trunk flexion after the perturbation by the elderly group observed, it is suggested that while walking everyday a good routine of walking with an upright posture should be developed.

• 한국응용과학기술학회지
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• 제37권3호
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• pp.496-508
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• 2020

This study reviews studies on the core stabilization of respiratory muscle training for the elderly health. Previous research data and presenting basic literature data suggest that respiratory activation is an important mechanism for core strengthening via exercise interventions for the elderly. The review found that first, the mechanism of improving the respiratory muscles weakened by aging to address the loss of core function due to old age sarcopenia among the elderly results entails promoting the autonomic nervous system by focusing on the respiratory muscle activation pattern, the core muscle sensation mobilized for body centering. Second, nerve roots, intraperitoneal pressure, and deep muscles in the trunk of the body can be promoted while controlling respiratory stimulation with cognitive feedback. Effortful inspiration increases the activation of respiratory assistive muscles and effortless exhalation can improve the core muscle mobilization by involving abdominal muscles. Third, through respiratory muscle training, the elderly can increase their awareness of spinal centering and improve the ability to control the deep core muscles that must be mobilized for core stabilization. In conclusion, respiratory muscle training to increase the utilization of the trunk muscles seems to be a useful core stabilization exercise for the elderly with chronic tension and joint degeneration.

• The Journal of Korean Physical Therapy
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• 제16권4호
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.