• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.311-327
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• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

• Physical Therapy Korea
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• v.11 no.4
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• pp.19-29
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• 2004

Many muscles of the trunk and hip are capable of contributing to the stabilization and protection of the lumbar spine. To have optimal effectiveness, a training program should include dynamic back/stomach/hip exercises. This study was designed to assess the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscle activities during various low back stabilization exercises. Participants were 26 healthy adults (13 males, 13 Females), aged 21 to 28 years. The surface electromyography (EMG) was recorded from the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken during 3 low back stabilization exercises. One-way analysis of variance with repeated measures was used to examine the difference, and a post hoc test was performed with least significant difference. A level of significance was set at p<.05. The significance of difference between men and women, and between the electromyographic recording sites was evaluated by an independent t-test. The EMG activity for the externus oblique and gluteus maximus muscles had significant differences among 3 exercises (p<.05). In males, the EMG activity for the external abdominal oblique muscle had significantly increased differences during exercises 1 and exercise 2 (p<.05). The gluteus maximus muscle had significantly increased differences during exercise 2 and exercise 3 (p<.05). In females, the multifidus muscle had significantly increased difference during exercise 3 (p<.05), the external abdominal oblique muscle had significantly increased difference during exercise 1 (p<.05). and the gluteus maximus muscle had significantly decreased difference during exercise 3 (p<.05). The results were that the external abdominal oblique muscle was apparently activated during the curl-up exercise in females and males, and the multifidus muscle was apparently activated during the bridging exercise in females and during the sling exercise in males and females.1)In comparison of the %MVC between males and females, exercise 2 and exercise 3 apparently activated of the multifidus and gluteus maximus muscles in both males and females (p<.05). The EMG activity of the gluteus maximus muscle of the males significantly increased during exercise 2 and exercise 3 (p<.05). The EMG activity the multifidus muscle of the females was significantly increased during exercise 2 and exercise 3 (p<.05). More research is needed to understand the nature of motor control problems in the deep muscles in patients with low back pain.

• Physical Therapy Rehabilitation Science
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• v.6 no.1
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• pp.1-6
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• 2017

Objective: There are many types of exercises with upper and lower-limb action for activation of abdominal muscles for trunk stabilization. A comparison of the different exercise methods been very useful to enhance the result from the exercise for treatment. The purpose of this study was to investigate through surface electromyography (EMG) the changes in abdominal muscle activity during the performance of three different dead-bug exercise methods performed at three different speeds. Design: Cross-sectional study. Methods: The subjects were 30 healthy adults (13 males and 17 females). We instructed the subjects to perform three different dead-bug exercises. We also applied three different speeds to the dead-bug exercises; 60 bpm, 90 bpm, and 120 bpm with use of a metronome. The assessment of EMG was percentage of maximal voluntary isometric contraction on the rectus abdominis (RA), external oblique (EO), and internal oblique (IO). Results: EMG activation of the RA, EO and IO muscles was significantly greater at the higher speed (p<0.05). There was a significant increase in abdominal muscle activity during the dead-bug exercise performed with both the upper and lower extremities compared to that with only the upper extremity or the lower extremities (p<0.05). Conclusions: These findings demonstrate that the performance of the dead-bug exercise with both the upper and lower extremities combined at a high speed is more effective compared to other exercises. Therefore, it is suggested that more favourable and effective outcomes may occur when the type and speed of the exercise is chosen appropriately.

• Physical Therapy Korea
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• v.18 no.1
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• pp.37-46
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• 2011

The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.

• Physical Therapy Korea
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• v.11 no.1
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• pp.19-25
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• 2004

The purpose of this study was to investigate the effects of backrests of varying degrees ($90^{\circ}$, $100^{\circ}$, $110^{\circ}$) on three abdominal muscles (upper rectus abdominis, external oblique, internal oblique) and back extensor activation during lower extremity exercise. The three different conditions during bilateral knee extention exercise were: (1) leaning on a chair with a $90^{\circ}$ backrest, (2) leaning on a chair with a $100^{\circ}$ backrest, (3) leaning on a chair with a $110^{\circ}$ backrest. Fifteen healthy muscle subjects (mean age=24.2 years [SD=2.96], mean height=175.6 cm [SD=7.46], mean weight=69.1 kg [SD=7.36]) with no history of neuromusculoskeletal disease voluntarily participated in this study. Electromyography was used to collect muscle activation, and the muscle activation was expressed as a percentage of maximal voluntary isometric contraction (%MVIC). Repeated one-way analysis of variance (ANOVA) was used to determine the statistical significance. The results were as follows: (1) upper rectus abdominis, external oblique, internal oblique activation measured significantly lower. (2) measured significantly lower when lower degree.

• Journal of Korean Physical Therapy Science
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• v.13 no.3
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• pp.15-25
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• 2006

The purpose of this study was to investigate effects of different chair type (with backrest chair and without backrest chair) and pelvic position (anterior pelvic tilting and posterior pelvic tilting) on three abdominal muscles (upper rectus abdominis, external oblique, internal oblique) and back extensor activation during lower extremity exercise. The four different conditions during bilateral knee extension exercise were: (1) leaning on backrest chair with anterior pelvic tilting, (2) leaning on backrest chair with posterior pelvic tilting, (3) anterior pelvic tilting without backrest chair, and (4) posterior pelvic tilting without backrest chair. Fifteen healthy male subjects with no history of neuromusculoskeletal disease voluntarily participated in this study. Electromyography (EMG) was used to collect muscle activation data, and muscle activation data was expressed as a percentage of maximal voluntary isometric contraction (%MVIC). One-way repeated analysis of variance (ANOVA) was used to determine the statistical significance, and Bonferroni comparison was used as a post hoc test. The results of this study were the following: (1) Erector spinae activation was significantly lower in posterior pelvic tilting without backrest compared with that in leaning on backrest chair with anterior pelvic tilting. (2) Upper rectus abdominis activation was significantly lower than erector spinae in all four different chair type and pelvic tilting conditions.

• Physical Therapy Korea
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• v.6 no.2
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• pp.16-31
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• 1999

The purpose of this study was to assess the fatigue in lumbar and abdominal muscles in patients with chronic low back pain compared with normal subjects using spectral analysis with mean power frequency and median power frequency. The experimental group consisted of twenty subjects who had experienced chronic low back pain for over one year after the onset day. A control group consisted of twenty normal subjects with no history of low back pain. All subjects stood in an apparatus to perform sustained contraction in the lumbar and abdominal muscles for 30 seconds with 60% maximal voluntary isometric contraction (MVIC). The resulting electromyographic (EMG) recorded time serial data were transformed into frequency serial data by Fast Fourier Transformation (FFT). The results were as follows: 1) lumbar muscles measured, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group group (p<0.05). In measured two abdominal muscles (inferior rectus abdominis, obliquus externus abdominis) except superior rectus abdominis, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group (p<0.05). 2) In all three (longissimus thoracis, iliocostalis lumborum, multifidus) lumbar muscles measured, the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). In the two (inferior rectus abdominis, obliquus externus abdominis) abdominal muscles measured (superior rectus abdominis not included), the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). These results suggest that in patients with chronic low back pain there is a trend for more fatigue to occur in both lumbar and abdominal muscles than in the normal control group. This would seem to suggest that in treatment programs for patients with chronic low back pain, improvement of endurance in all trunk muscles should be considered.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.5 no.2
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• pp.35-45
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• 2007

The purpose of this study was to examine spiral way movement of a trunk exerts on the movement ability. The details established to achieve for this article. This examination confirmed the weight, weight/height2 index, ratio of lumbar to pelvic, musculoskeletal quantity, push up for 2 minute, pitch a ball and voluntary isometric contraction with flexion and extension of knee joint of the subjects with spiral direct movement. Healthy eighteen subjects who understand fully the significance of procedure, consented to a plan, without neuromuscular disease were participated in two groups of experiment. The group were a spiral movement(9), rectilinear movement(9). Trunk movement tested 2 sessions of a spiral movement and rectilinear movement with a push up for 2 minute, 5days per a week, for the 4 weeks. This experiment tested 3 times with a sufficient rest for fatigue limitation. An analysis of the results used a paired samples t-test for difference from before and after experiment. The following results were obtained; At an internal change of the body, the musculoskeletal quantity was increased significantly to spiral movement group, but the weight was increased significantly, the musculoskeletal quantity was not significant to rectilinear movement. The movement ability evaluation for a external change was increased significantly in a push up for 2 minute, pitch a ball, isometric contraction with extension of knee joint of a spiral movement group, but a push up for 2 minute was increased significantly in a push up for 2 minute on the abdominal muscle training of a rectilinear movement group. As compared with a rectilinear movement, a spiral movement was more effect by cooperation with nerve and musculoskeletal system and an increase in movement ability was caused by learning acknowledgment, muscular reeducation. These results lead us to the conclusion that a spiral movement of trunk was more effect than a rectilinear movement, the coordination of nerve and musculoskeletal system was of importance of Multi-direction movement. Therefore, A further studies concerning the therapeutic exercise intervention and active-dynamic analysis could enhance the development of the most effect on the trunk.

• Physical Therapy Korea
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• v.12 no.1
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• pp.1-10
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• 2005

The purpose of this study was to verify the most effective spinal stabilization exercises program by comparing the activities of muscles contributing to spinal stabilization during four types of exercises using a sling and a mat. Twenty healthy males were recruited and each subjects performed four types of exercises. Exercise 1 was performed in a quadruped position with the subjects lifting the left arm and the opposite leg on the mat. Exercise 2 was performed in a prone position while holding a sling with the right hand and the left knee was fully extended while lifting the left arm and right leg. Exercise 3 was performed in quadruped position while holding a sling with one the right hand and lifting the opposite arm and leg. In exercise 4, subjects were instructed to maintain a balance push-up position while holding slings with both hands in 10 cm forward reaching with extended elbows. Electromyographic(EMG) activities were recorded from the multifidus, external oblique, internal oblique, abdominal rectus, and erector spinalis muscles during the exercises. The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary isometric contraction (MVIC) of each muscle. Repeated ANOVA and Bonferroni's tests were used to compare the differences in the muscle activity according to the types of exercise. The EMG amplitudes of all the muscles were significantly different according to the types of exercises (p<.05). The highest EMG activities of each muscle was as follow; multifidus was 73.38%MVIC in exercise 3, the erector spinalis was 40.03%MVIC in exercise 3, the external oblique was 135.88%MVIC in exercise 4, the internal oblique was 128.60%MVIC in exercise 4, and the rectus abdominalis was 95.24%MVIC in Exercise 4. The types of exercises showed a significant difference in composition rate of EMG amplitudes of each muscle (p<.05). EMG composition rate of the multifidus was high in exercise 1 and 3. However, EMG composition rates of the external oblique, internal oblique, and the rectus abdominals were high in exercise 2 and 4. These results showed differences in EMG activities of muscles contributing to trunk stabilization during different therapeutic exercises. Therefore, the type of exercise should be carefully selected to effectively strengthen a specific trunk stabilizer.