• 대한통합의학회지
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• 제8권4호
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• pp.171-181
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• 2020

Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.8-14
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• 2023

Background: Excessive hamstring (HS) activation due to the weakness of the gluteus maximus (GM) causes pain in the hip joint. A single-leg deadlift is a hip extensor exercise, especially GM, that includes functional movements in daily life and complex multi-joint training. In single-leg deadlift, the muscle activity depends on the forward trunk lean angle, and it's necessary to study which muscles are used dominantly depending on the angle. Objects: The purpose of this study was to compare the effect on the muscle activity of the GM and HS during single-leg deadlift according to different forward trunk lean angles and the ratio of the GM vs HS (GM/HS). Methods: Twenty-one healthy female participants were recruited. The muscles activities of the GM, HS and the GM/HS ratio were measured through electromyography during single-leg deadlift according to three condition of forward trunk lean angles (30°, 60°, and 90°). Results: The GM and HS activities significantly differed among three conditions (p < 0.05). GM/HS ratio was significantly higher at 30° and 60° of forward trunk lean compared to 90°. Moreover, the GM activity was significantly higher at 60° of forward trunk lean than at 30° (p < 0.05). Conclusion: The single-leg deadlift at 60° of forward trunk lean is a proper GM muscle strengthening exercise.

• 대한물리의학회지
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• 제5권3호
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• pp.405-412
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• 2010

Purpose : The purpose of this study was to assess the effects of the trunk muscle activity on bridging exercise according to the knee joint angle. Methods : Twenty-five healthy adults volunteered to participate in this study. Subjects were required to complete following four bridging exercises; knee joint flexion $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. Muscle activity was measured by QEMG-4 system(LXM 3204, Laxtha Korea). A repeated measures of one-way ANOVA with post-hoc Bonferroni's correction was used to determine the influence of bridging exercise on muscle activity for each muscle and descriptive statistics was used to determine local/global muscle ratio. Results : The internal oblique of bridging exercises $120^{\circ}$, $90^{\circ}$ showed significantly(p<.05). The erctor spinae of all bridging exercises showed significant excepted between $60^{\circ}$ and $45^{\circ}$(p<.05). Median of internal oblique/rectus abdominis ratio of $120^{\circ}$ was 4.41, $90^{\circ}$ was 3.94, $60^{\circ}$ was 3.58, $45^{\circ}$ was 3.39. Median of internal oblique/external oblique ratio of $120^{\circ}$ was 2.66, $90^{\circ}$ was 2.43, $60^{\circ}$ was 2.87, $45^{\circ}$ was 2.64. Conclusion : Angular motion decreasing with knee joint flexion made erector spinae activation increase. on the other hand, as decreasing abdomen muscle activation, the more performing motor learning is required for abdomen muscle strength and co-contraction for the trunk stabilization.

• The Journal of Korean Physical Therapy
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• 제24권5호
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• pp.300-305
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• 2012

Purpose: This study examined the muscle activity of the trunk muscles during weight shifting exercises on a stable and unstable surface. Methods: Ten healthy young subjects (4 males, 6 females) with no medical history of lower-extremity or lumbar spine disease were enrolled in this study. The muscle activity was recorded using surface electromyography (EMG) electrodes from the both sides of the external obliques and erector spinae muscles. Results: The EMG activities of the both rectus abdominalis, both external obliques and erector spinae muscles were significantly higher when the weight shifting exercise was performed on a firm surface than when a balance pad with a balance ball was used. In weight shifting exercises, the EMG activity of the contralateral external obliques and erector spinae muscles was significantly higher than that of the ipsilateral external obliques and erector spinae muscles under all three support surface conditions. Conclusion: Performing weight shifting exercise using an unstable surface is a useful method for facilitating the trunk-muscle strength and trunk stability.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.255-298
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• 2003

The purpose of study was to evaluate effects of a trunk muscle strength training on sitting balance of children with spastic cerebral palsy. Five individuals with spastic cerebral palsy(three females. two males; mean aged 6.6) participated three times a week over 6 weeks. Five individuals with spastic cerebral palsy(three females. two males; mean aged 7.0) who did not receive strength training served as control. BPM(Balance Performance Moniter) was used to measured sitting balance and EMG(electromyograph, NORAXON, USA) was used to measured activities of abdominal and erector spine muscle. The obtain result are as follows. 1. The result of this study were following that maximum perturbation area and perturbation velocity were significantly reduced strength training group compared with control group(p<.05). 2. The result of this study were following that maximum perturbation area and perturbation velocity were significantly reduced after strength training compared with pre strength training in strength training group(p<.05). 3. The result of this study were following that maximum perturbation area and perturbation velocity were not significantly reduced at interval of six week in control group(p<.05). 4. The result of this study were following that abdominal muscle activity was significantly increased strength training group compared with control group(p<.05). 5. The result of this study were following that erector spine muscle activity was significantly increased strength training group compared with control group(p<.05). 6. The result of this study were following that abdominal muscle activity and erector spine muscle were significantly increased after strength training compared with pre strength training in strength training group(p<.05). 7. The result of this study were following that abdominal muscle activity and erector spine muscle were not significantly increased at interval of six week in control group(p<.05). In conclusion, the result of this study suggest that improved sitting balance and increased activities of trunk muscle by trunk strength training in spastic cerebral palsy. The result was proposed that therapeutic approach of spastic cerebral palsy with impaired sitting balance should use trunk strength training.

• 대한물리의학회지
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• 제4권4호
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• pp.221-229
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• 2009

Purpose : The purpose of this study was to assess the effect of bridging stabilization exercises of trunk muscles activity on a Swiss ball according to change of position. Methods：30 healthy university students volunteered to participate in this study. Subjects were required to complete following three exercise positions. Exercise position 1; Supine bridge with Swiss ball, Exercise position 2; Side bridge with Swiss ball, Exercise position 3; Prone bridge with Swiss ball. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. Results : A repeated measures of ANOVA with Duncan's correction was used to determine the influence of exercise type on muscle activity for rectus abdominis, external oblique, erector spinae. The erector spinae of exercise position 1 showed significantly higher muscle activity than exercise position 2, 3(p<.05). The external oblique of exercise position 2, 3 showed significantly higher muscle activity than exercise position 1(p<.05). The rectus abdominis of exercise position 3 showed significantly higher muscle activity than exercise position 1, 2(p<.05) Conclusion： These results indicate that muscle activity can be influenced by addition of a Swiss ball in bridging exercises. It is recommend to use a Swiss ball for trunk stabilization exercise.

• 한국전문물리치료학회지
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• 제27권3호
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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.

• PNF and Movement
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• 제17권3호
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• pp.379-389
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• 2019

Purpose: This study examined the effects of wheelchair handle directions on the trunk muscle activity of adult males when climbing ramps. It also evaluated the wheelchair attendant's physical discomfort during tasks. Methods: Healthy males aged over 20 years were chosen and the direction of wheelchair handle grip was randomly selected. The grips included a general grip with ulnar deviation, a medial grip with wrist pronation, and a neutral grip with a neutral wrist. The trunk muscle activity was measured using surface electromyography. Furthermore, the physical discomfort of wheelchair attendants was subjectively evaluated using the Borg CR-10 Scale, which rates the perceived exertion. In addition, the SPSS 18.0 program was used perform repeated measure ANOVA to compare muscle activity and subjective discomfort during the interventions. The contrast test was also conducted with a significance level (α) of 0.05. Results: There was significant difference between the general grip and the medial grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). In addition, there was significant difference between the general grip and the neutral grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). Further, there was significant difference between the general grip and the neutral grip in subjective discomfort (p<0.05). Conclusion: In this study, adult male trunk muscle activity and subjective discomfort were lowest when using the neutral grip while climbing ramps. Accordingly, we suggest that neutral grips will help improve the function of the musculoskeletal system and reduce the subjective discomfort by putting less strain on the trunk muscles and maximizing efficiency with less force.

• 한국전문물리치료학회지
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• 제16권2호
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• pp.31-39
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• 2009

This study is performed to investigate the difference of the spinal stability system with and without low back pain. There were 9 participants with low back pain and 9 asymptomatic subjects to be recruited, they were measured thoracic and lumbar curvature, trunk muscle activation in upright sitting postures and slump sitting, back muscle endurance, and lumbar proprioception. Spinal curvature and surface electromyography of 4 trunk muscles were measured in an upright sitting postures and slump sitting in 18 subjects. The result of the study was that there were significant differences between the groups in spinal curvature (p<.05), significantly higher external oblique activity and less internal oblique in the low back pain group than the healthy subjects (p<.05), and significantly less proprioception in the low back pain group (p<.05). But there was not a significant difference between the trunk muscle endurance groups. According to the result, the low back pain group had greater thoracic extension and higher global muscle activity in the upright sitting posture and less proprioception. This study was useful to suggest postural training for normal muscle activation, selective muscle strengthening to prevent chronic deterioration, and helpful in making a treatment plan to indicate a synthetic care method that includes increasing proprioception.

• 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.