• 대한통합의학회지
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• 제10권3호
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• pp.131-140
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• 2022

Purpose : Although many studies have explored the effect of seating side angles on the spinal curve and surrounding muscles during seating, only a few studies have investigated the effect of different seating face angles on different lower limb and deep trunk muscles. Therefore, this study investigated the effects of seating surface angles (0 degrees, 10 degree anterior, and 10 degree rear) on lower extremity and deep trunk muscles in healthy adults. Methods : Thirty people were asked to sit once on each seating surface three times during the day, and their muscle thicknesses were measured by ultrasound while sitting. The method of sitting was the same when sitting on the three seating surfaces. Results : From the comparison results of the muscle thicknesses according to the seating surface angles, a significant difference existed in the muscle thicknesses of the vastus medialis, vastus medialis oblique, vastus intermedius, soleus and gastrocnemius (p<.05). However, no significant difference was found in the transversus abdominis, internal obliques, rectus femoris and vastus lateralis (p>.05). Conclusion : Our findings revealed that the lower back load decreases, the leg load increases, and the legs specific muscles are affected as the body tilts forward when sitting on the seating surface inclined forward. Therefore, it is possible to suggest a forwardly inclined seating surface that reduces lower back loads and utilizes the posture-maintaining muscles of the legs when sitting in a person with a poor sitting posture or lower back pain at ordinary times.

• Journal of Yeungnam Medical Science
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• 제23권1호
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• pp.1-9
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• 2006

Breast reconstruction provides dramatic improvement for patients with severe deformity. The reconstruction not only restores aesthetically acceptable breast for patients with mastectomy deformity but also recovers psychological trauma of 'losing feminity' after the cancer mastectomy. There are many options for breast reconstruction from simple prosthetic insertion to a flap operation using autologous abdominal tissue. The choice of operation method depends on the physical condition of the patient, smoking habits, and economic status. Among the many options, the method that uses the lower abdominal tissue is known as the TRAM (transverse rectus abdonimis myocutaneous) flap. Since the introduction of the TRAM flap in 1982 by Hartrampf, the art of breast reconstruction using lower abdominal tissue has been progressively refined to pedicle flap, muscle-sparinga TRAM flap, and recently there have been exciting and revolutionary changes associated with the adoption of the concept of perforator flap. This refined method of breast reconstruction utilizes lower abdominal tissue nourished by the deep inferior epigastric perforator (DIEP). With the DIEP free flap, almost all of the rectus muscle and anterior rectus sheath are preserved and the donor morbidity is minimized. Different from previous flap methods using lower abdominal tissue, DIEP free flap method preserves function of the rectus muscle completely. 1) Understanding the entire progression of breast reconstruction methods using lower abdominal tissue is necessary for plastic surgeons; the understanding of each step of the exciting progression and the review of the past history of the TRAM flap may provide insight for future development.

• 대한한의학회지
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• 제32권3호
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• pp.1-9
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• 2011

Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

• 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.

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.92-98
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• 1996

The rectus abdominis myocutaneous flap is frequently used in the field of plastic and reconstructive surgery such as breast reconstruction and as a donor of free tissue transfer. Major problems with this flap is bulkiness, the possibility of postoperative abdominal herniation and muscle weakness following the removal of the rectus abdominis muscle. We used paraumbilical perforator based skin flap fed by a muscle perforator from the deep inferior epigastric artery, with no or little muscle and fatty tissue, in three patients for the resurfacing of relatively wide and thin defects. This technique has all of the advantages of the conventional rectus abdominis myocutaneous flap with decreased possibility of postoperative abdominal herniation or muscle weakness. Another challenging merit is possibility of skin flap thinning.

• The Journal of Korean Physical Therapy
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• 제22권6호
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• pp.7-12
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• 2010

Purpose: This study investigated changes in the thickness of the transversus abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO) muscles between crook lying and wall support standing positions during abdominal hollowing (AH), using ultrasound imaging. Methods: Experiments were conducted on 20 healthy male adults (mean age=$22.45{\pm}4.08$ years) who voluntarily agreed to participate in the experiments. The changes in the thickness of the subjects' abdominal muscles were measured during AH in crook lying and wall support standing positions. Results: The difference in the thickness of TrA between the two positions during AH was statistically significant, but the differences in the thicknesses of IO and EO were not significant. Conclusion: Activity of the TrA, which is a deep muscle, was stimulated in the standing position, which is, therefore, more functional than the crook position, but the activities of IO and EO muscles did not decrease. Therefore, various methods to induce the activity of TrA while decreasing the activities of IO and EO, in the functional standing position that can stimulate deep muscles, need to be designed.

• 대한정형도수물리치료학회지
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• 제20권1호
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• pp.21-26
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• 2014

Background: This study was aimed to determine the effects of deep abdominal muscle exercises (DAME) and thoracic mobility exercises (TME) on pulmonary function. Methods: This study was conducted with 22 college students who are in their 20s and have no problem carrying out activities of daily living. All subjects were randomly assigned to either the DAME group (11) or the TME group (11) to undertake the exercises for 2 weeks. To measure pulmonary function of subjects, forced vital capacity (FVC), forced exploratory volume in 1 second (FEV1) and peak expiratory flow (PEF) were measured using chest graph. Chest expansion of subjects was also measured with tape ruler. These measurements were performed on the first day before the exercise program started and on the next day after the 2-week exercise program was completed. A paired-t test was performed to compare the differences in pulmonary function before and after the exercise program, and an independent t-test was performed to compare the two groups. Results: The results of this study were as follows: 1) In comparison of pre- and post-exercise changes in the DAME and TME groups, both groups showed significant increase in chest expansion and PEF after the exercise program, compared with the baseline data (p<.05). Both groups also demonstrated improvements in FVC and FEV1 after the exercise program, compared with the baseline data. However, the differences were not statistically significant (p>.05). 2) The comparison of the DAME and TME groups revealed no significant differences in chest expansion, FVC, FEV1 and PEF (p>.05). Conclusion: It is therefore concluded that both DAME and TME were effective in improving pulmonary function.

• PNF and Movement
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• 제19권3호
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• pp.321-329
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• 2021

Purpose: The abdominal drawing-in maneuver (ADIM) is an exercise that selectively strengthens deep abdominal muscles. It is reported to be effective in strengthening those muscles when using a pressure biofeedback unit. However, multiple factors of bridge exercise seem to bring exercise result of ADIM without stabilizer as they influence execution of ADIM. Therefore, the purpose of this study was to compare changes in the thickness of deep abdominal muscles through the ADIM exercise incorporating either a stabilizer or the bridge exercise. Methods: Thirty healthy adults who had voluntarily given their consent were selected as the subjects. A diagnostic sonograph was used to measure the thickness of the subjects' transverse abdominis, internal oblique, and external oblique muscles. First, the thickness of the subjects' deep abdominal muscle was measured while maintaining the ADIM using the stabilizer. After three minutes of rest, the thickness was measured again while the subjects maintained the ADIM with the bridge exercise. Results: In both exercises, the thickness of the transverse abdominis showed a statistically significant increase, with a more significant increase while executing the ADIM using the bridge exercise. In both exercises, the thickness of the internal oblique showed a statistically significant increase, with a more significant increase while executing the ADIM using the bridge exercise. The thickness of the external oblique showed a statistically significant increase only in the ADIM using the bridge exercise. Conclusion: Though strengthening is not as selective as the ADIM using a stabilizer, the ADIM using the bridge exercise has a more increased thickness of the transverse abdominis and the internal oblique than that of the internal oblique. Based on the outcome of this study, the ADIM using the bridge exercise without a stabilizer can selectively strengthen deep abdominal muscles even more.

• Physical Therapy Rehabilitation Science
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• 제4권1호
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• pp.11-16
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• 2015

Objective: Prone bridge exercise is one of the core strengthening exercise for improving abdominal, lower and upper extremity muscles. In addition, coactivation of the trunk muscles and extremities is important for treatment of low back pain. This study aimed to investigate the correlation between the thickness, cross-sectional area of the target muscle, and endurance during prone bridge exercise. Our hypothesis was that an increase in muscle thickness is positively related to the hold time for the static prone bridge exercise. Design: Cross-sectional study. Methods: Fourteen healthy university students (8 men and 6 women) voluntarily participated in the study at Sahmyook University. Hold time for the prone bridge with one and both legs was measured. The resting and contracted thickness of the lateral abdominal, rectus femoris, and triceps muscles was measured using rehabilitative ultrasound imaging. The correlation between muscle thickness and endurance for maintenance time was evaluated. Results: The prone bridge with both legs and the contraction thickness of the triceps muscle showed a positive correlation (r=0.692, p<0.05); the prone bridge with one leg and the contraction thickness of the internal oblique and transversus abdominis muscles showed a positive correlation (r=0.545, 0.574, p<0.05, 0.05, respectively). Conclusions: Endurance for the prone bridge exercise with a stable support surface is correlated with the contraction thickness of arm muscles; the prone bridge exercise with an unstable support surface is correlated with the contraction thickness of the deep abdominal muscles.

• 한국전문물리치료학회지
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• 제16권3호
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• pp.9-15
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• 2009

The purpose of this study was to examine contraction of abdominal muscles on surface electromyographic (EMG) activity of superficial cervical flexors, rib cage elevation and angle of craniocervical flexion during deep cervical flexion exercise in supine position. Fifteen healthy subjects were participated for this study. All subjects performed deer cervical flexion exercise with two methods. The positions of two methods were no volitional contraction of abdominal muscles in hook-lying position with 45 degree hip flexion (method 1) and 90 degrees hip and knee flexion with feet off floor for inducing abdominal muscle contraction (method 2). Surface EMG activities were recorded from five muscles (sternocleidmastoid, anterior scaleneus, recuts abdominis, external oblique, internal oblique). And distance of rib cage elevation and angle of craniocervical flexion were measured using a three dimensional motion analysis system. The EMG activity of each muscle was normalized to the value of reference voluntary contraction (%RVC). The EMG activities, distance of rib cage elevation. and angle of craniocervical were compared using a paired t-test between two methods. The results showed that the EMG activities of sternocleidmastoid and anterior scaleneus during deep cervical flexion exercise in method 2 were significantly decreased compared to method 1 (p<.05). Distance of rib cage elevation and angle of craniocervical flexion were significantly decreased in method 2 (p<.05). The findings of this study indicated that deep cervical flexion exercise with contraction of abdominal muscles could be an effective method to prevent substitute motion for rib cage elevation and contraction of superficial neck flexor muscles.