• 한국전문물리치료학회지
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• 제24권3호
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• pp.10-20
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• 2017

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.

• 동의생리병리학회지
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• 제26권4호
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• pp.557-565
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• 2012

The purpose of this study was to examine the effect of acupuncture on trunk flexors compared with trunk extensors in patients with chronic low back pain. The experimental group was treated with acupuncture on trunk flexors. The control group was treated with acupuncture on trunk extensors. Acupuncture treatment was performed 12 sessions over the course of 6 weeks. Volunteers who satisfied the requirements were enrolled in the study. Chronic low back pain was evaluated based on the VAS for bothersomeness, VAS for pain intensity at every treatment and 8, 12 and 24 weeks after starting the treatments, and ODI, SF-36 and BDI before and after treatments and 8, 12 and 24 weeks after starting the treatments. The VAS score for bothersomeness significantly decreased after treatment for up to 24 weeks after starting the treatments in both group (p<0.05). The VAS score for bothersomeness in the experimental group decreased more rapidly than that of the control group with statistical significance (p<0.05). The VAS score for pain intensity, ODI, SF-36 and BDI significantly improved after treatment for up to 24 weeks after starting the treatments in both group (p<0.05). The VAS score for pain intensity, ODI, SF-36 and BDI in the experimental group showed more rapid improvement than those of the control group. But, there were no statistical significances. Treating trunk flexors using acupuncture was more effective in decreasing the degree of bothersomeness caused by chronic low back pain than treating trunk extensors with acupuncture. There is a need to perform further studies.

• 대한물리의학회지
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• 제13권4호
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• pp.75-84
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• 2018

PURPOSE: This study was conducted to determine the effects of whole-body tilt exercise with visual feedback on trunk control, strength, and balance in patients with acute stroke. METHODS: The study included 18 patients with acute stroke who were randomly allocated to a Whole Body Tilt Exercise Group (WBTEG, N=9) and a General Trunk Exercise Group (GTEG, N=9). The WBTEG conducted whole-body tilt exercises with visual feedback, and the GTEG performed general trunk exercises. Both groups performed the exercises five times a week for 4 weeks. Outcomes were assessed using the trunk impairment scale (TIS), the trunk flexor and extensor strength test, the static balance test, and the Brunel Balance Assessment. RESULTS: After 4 weeks of intervention, both groups showed significantly improved TIS scores, muscle strength, and balance components (p<.05 in both groups). However, the improvement in TIS, muscle strength, and static balance in the WBTEG was significantly better than that in the GTEG (p<.05). CONCLUSION: Although both groups in this study showed post-intervention improvement, patients from the WBTEG who received visual feedback demonstrated more improvement. These findings indicate that whole-body tilt exercise with visual feedback may be effective at improving trunk control, trunk muscle strength, and balance in patients with acute stroke. Further studies are needed to gain a better understanding of the effectiveness of whole-body tilt exercise in patients with acute stroke.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.37-48
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• 2015

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 1995년도 추계학술대회 논문집
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• pp.315-318
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• 1995

In this paper, an optimal trunk trajectory for stable walking of biped robots is expressed as a simple differential equation, which is then solved by numerical methods. We used ZMP (Zero Moment Point), the virtual total ground reaction point within the region of the supporting food, as the criterion of stability of biped robot walking. If the ZMP is located outside of the stable region in dynamic walking, biped robots fall down. The biped robot considered in this paper consists of two legs and a trunk. The trajectories of the two legs and the ZMP of the biped robot are determined such that they are similar ti those of a human. Based upon those trajectories, the trunk trajectory is solved by numerically integrating differential dynamic equations. Leg motions are controlled by the computed torque control method. The effectiveness of control algorithm as well as the trajectories is confirmed by computer simulations.

• 대한물리치료과학회지
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• 제29권2호
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• pp.1-13
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• 2022

Background: This research was conducted to understand balance training in trunk control, balance, and walking in stroke patients. Design: Randomized controlled trial. Methods: The subjects included 40 stroke patients, of whom 20 undertook balance training using visual information and the other 20 undertook balance training using balance boards. Using visual feedback, the balance training group used a training program within the static balanced evaluation tool, while the balance training group trained using a balance board. All subjects underwent 20 mins of neurodevelopmental treatment, and both target groups underwent 10 mins each of balance training by using either visual feedback or a balance board. The treatment period lasted a total of 4 weeks, twice a day. Trunk control before and after training was evaluated with the Trunk Impairment Scale. Balance capability was assessed by the Berg Balance Scale, Functional Reach Test, Timed Up and Go test, and Static balance measurement tool. Walking capacity was measured using gait measuring equipment, and cadence and velocity were measured. Results: Both groups showed a significant improvement in their interstitial control, balance, and gait ability after the experiments compared to before the experiments (p<0.05). The difference between the two groups was not significant. The visual feedback balance training group showed a more substantial improvement than the balance board training group. Conclusion: In this study, we found that the balance training combined with visual feedback contributes to improving trunk control, balance, and gait in patients with hemiplegia due to stroke. In addition to this, I believe that balanced training combined with visual feedback can be used as a training method when considering patients who lack interstitial control, balance, and gait ability.

• The Journal of Korean Physical Therapy
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• 제26권1호
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• pp.27-32
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• 2014

Purpose: The purpose of the study was to comparison of trunk muscle activity during static standing position and standing position on therapeutic climbing wall of adult. Methods: Study subject is arbitrarily classified into 10 of experimental group and 10 control group among 20 of adult. Trunk activity measured as rectus abdominalis, external oblique, internal oblique, erector spinae. Control group maintains that center of gravity of trunk pass the front of shoulder, pelvis, knee and ankle on stable surface with putting legs apart more than shoulder width. Experimental group had static exercise on 4 by 3 meter, 90 degree of Therapeutic climbing wall. Starting position is that putting arms and legs apart more than shoulder width. In order to compare the effect of it between the groups, independent t-test was used. Results: According to the test result, significant difference between among rectus abdominalis, erector spinae the experimental groups. And external oblique, internal oblique muscle atvity is no significant difference experimental groups between among the control groups was observed. Conclusion: Trunk muscle activation is activated to standing position on the Therapeutic Climbing Wall more than static standing position.

• 대한물리의학회지
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• 제15권4호
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• pp.37-45
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• 2020

PURPOSE: The purpose of this study was to identify the effects of neck stabilization exercise combined with trunk stabilization exercise on balance and gait function in patients with chronic stroke. METHODS: Twenty-two chronic stroke patients were included in this study. The experimental group subjects (n = 11) performed neck stabilization (15 min) and trunk stabilization (15 min) exercises, while the control group subjects (n = 11) performed trunk stabilization exercise only for 30 min. Before and after the intervention, the subjects underwent static balance and gait testing. RESULTS: The 95% confidence ellipse area, center of pressure (COP) path length, and COP average velocity were significantly lower in both groups after the intervention compared to before intervention (p < .05). The average stance force on the affected side increased significantly in both groups after the intervention (p < .05). The changes in the static balance variables were larger in the experimental group than in the control group. The cadence, gait velocity, and single leg support increased significantly in both groups after intervention (p < .05). The changes in the gait variables were larger in the experimental group than in the control group. CONCLUSION: Trunk stabilization is a beneficial intervention, but the combination of neck stabilization with trunk stabilization is a more effective method to increase the gait and static balance in chronic stroke patients.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.63-70
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• 2010

Purpose: In this study, children with cerebral palsy were treated for 8 weeks using horse riding trunk proprioception, stability and posture to investigate the effect of hippotherapy in the field of physical therapy. Methods: A total of 18 subjects were divided into an experimental group treated by horseback riding and a control group. Both groups were evaluated pre- and post-treatment. Trunk proprioception was measured three times in the sitting position with their eyes and ears closed to reach the target position the angle error of the mean was calculated. Trunk stability was measured using a forceplate and the data were used to calculate the postural sway path & postural sway velocity. Posture was evaluated using the Posture Assessment Scale (PAS). Results: After hippotherapy, the experimental group showed a significant improvement in trunk proprioception, stability and posture (p<0.05), but the control group improved in posture only (p<0.05). Trunk proprioception, stability and posture was significantly different between the two groups (p<0.05). Conclusion: Eight weeks of hippotherapy is effective in improving trunk proprioception, stability, and posture. Research using this therapy should be studied further as a possible new therapeutic approach in the field of physical therapy.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.379-386
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• 2021

Objective: The purpose of this study was to systematically review the trunk impairment scale that are used to assess the trunk control of stroke patients. Design: A systematic review Methods: Stroke subjects were categorized as acute, subacute, chronic. In this systematic review, the studies published between 2000 and 2020 were selected. A literature search using the keywords 'QUADAS', 'stroke', 'trunk impairment scale'. Data sources included RISS, GOOGLE Scholar and DBpia. We assessed the quality of assessment tools using Quality Assessment of Diagnostic Accuracy Studies tool. Results: We reviewed 18 studies. 7 of the 18 studies reported reliability results, 10 reported validity results. The QUADAS tool quality evaluation of 17 literatures extracted except for one randomized control test among 18 literatures showed a range of 3 to 13 points. 5 of the 18 studies are presented with the Cronbach alpha coefficient indicating reliability using internal consistency, all of which are more than 0.8. All studies that presented test-retest reliability, intra-rater reliability, and inter-rater reliability showed high agreement with an intra-class correlation coefficient of 0.75 or more. Conclusions: A systematic review of the study of the application of the trunk impairment scale for stroke patients will help provide criteria for future studies and application of the trunk impairment scale in clinical practice.