• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.378-382
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• 2020

Purpose: This study aimed to examine the effects of forward head posture on the flexion-relaxation ratio (FRR) and muscle activity during sustained neck flexion and to investigate the correlation between craniovertebral angle and FRR. Methods: Nineteen subjects participated in this study and were allocated to a forward head posture (FHP) group or a non-forward head posture (NFHP) group. Craniovertebral angle (CVA) and FRR were measured in all subjects, and all participants performed a standardized cervical flexion-extension movement in two phases: Phase I, sustained cervical full flexion for 5s; and Phase II, cervical extension with the return to the starting position for 5s. The value of CVA has calculated three times, and the value of FRR was measured three times in order to obtain the mean value. Results: FRR values in the FHP and NFHP group were significantly different (p<0.05). Phase I was significantly different, but the Phase II was not significantly different between the FHP and NFHP group (p>0.05). There was a significant correlation between the muscle activity of Phase I and CVA (p<0.05). However, FRR and the muscle activity of the Phase II were not a significant correlation with the CVA (p>0.05). Conclusion: FHP increases the muscle activity of the cervical erector spinae during sustained neck flexion and reduces FRR, which can cause fatigue in the cervical erector spinae. In addition, for those with a smaller CVA, muscle activity of the cervical erector spinae is increased during sustained neck flexion, which can increase neck muscle tension.

• Physical Therapy Korea
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• v.29 no.1
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• pp.79-86
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• 2022

Background: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP.

• Journal of Korean Physical Therapy Science
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• v.30 no.3
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• pp.23-30
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• 2023

Background: Flexion of cervical and lumbar joints is required when viewing a smartphone screen. Thus, these joints are overused, together with the surrounding joints and muscles. Long-term use of smartphones will cause changes in cervical and lumbar posture. The effect on forward head posture will vary, depending on the angle of cervical flexion start position in relation to the smartphone. This study investigated how forward head posture changes over time when using a smartphone at 20° and 40° cervical flexion start positions. Design: Cross-sectional study. Methods: Twenty-five subjects with a forward head posture angle of 35° or less participated in the study. A Forward Head Posture app on the participants' smartphones measured forward head posture 5 and 10 minutes after watching videos on their smartphones. Cervical range of motion was used to set a smartphone watching start posture of 20° and 40° of cervical flexion. Results: There was no significant difference in forward head posture, irrespective of cervical flexion start position, but the angle of forward head posture increased more at cervical flexion of 40° than at cervical flexion of 20°. There was no significant difference in what according to smartphone video viewing times, but the angle of forward head posture increased over time. Conclusion: An increase in forward head posture over time with smartphone usage poses a potential risk of neck and shoulder pain. Therefore, smartphone users should avoid prolonged screen time.

• Physical Therapy Korea
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• v.14 no.4
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• pp.7-13
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• 2007

The purpose of this study was to investigate correlations among objective measurements of spasticity in patients with brain lesions. Thirty-two stroke and traumatic brain injury subjects participated in the study. Spasticity was quantified using the knee first flexion angle, relaxation index obtained from a pendulum drop test, and the amplitude of a knee tendon reflex test. Pearson's product correlation coefficient was used to examine relationships among these measurements of spasticity. There was a significant positive correlation between the relaxation index and knee first flexion angle in patients with brain lesions (r=.895, p<.01). There was also significant negative correlation between the amplitude of knee tendon reflex and relaxation index (r=-.612, p<.01), and between amplitude and knee first flexion angle (r=-.537, p<.01). Thus, it is possible to use the knee first flexion angle as an objective measure of spasticity, rather than relaxation index, which is more complicated to obtain. Further studies are needed to explore the effects of functional improvement and long-lasting carryover effects of spasticity using a simple objective measure such as the knee first flexion angle from a pendulum test.

• Korean Journal of Applied Biomechanics
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• v.20 no.2
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• pp.117-127
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• 2010

The axes of upper forearm coordinate system have been considered as principal axis of each segment which was component of elbow joint. The purpose of this study was to verify whether the mean direction(principal axis) of instantaneous axes of rotation for pure flexion/extension motion coincided with the flexion/extension axis of upper forearm coordinate system. The same procedure was done for pronation/supination motion. Furthermore, it was tested indirectly that there was an interaction effect between the two rotational motions. The results showed that most segment coordinate axes statistically were not consistent with the mean directions of flexion/extension and pronation/supination axes of rotation. From the results, it would be concluded that the ISB coordinate systems was proved to be a little valid for human movement analysis. There also was an effect of pronation/supination angles on flexion/extension motion.

• Journal of Korean Physical Therapy Science
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• v.18 no.3
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• pp.63-69
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• 2011

Purpose : The purpose of study is activation of lumbar multifidus muscle by needle EMG during shoulder flexion in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymtomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. The needle EMG were measured activation of multifidus. Needle electrode was used to 28 gauge. The shoulder flexion movement used to activate the multifidus was then measured. Results : Results of the analysis showed that asymptomatic subjects had significantly larger multifidus muscle activation compared with CLBP subjects during shoulder flexion. Conclusion : This study will be used as multifidus measurement method of patient with chronic LBP. The multifidus muscle in chronic LBP patient clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Therefore chronic LBP patients necessary multifidus activation measurement with needle EMG.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2017.10a
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• pp.121-122
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• 2017

In this paper, the angles of flexion of bending the neck to touch the chest and extension of lifting the neck backwards to take the posture of looking up at the ceiling are measured. The basic angle of flexion is in the range of $45{\sim}50^{\circ}$ while the maximum range of angle of movement of flexion is $80{\sim}90^{\circ}$. Similarly, the basic angle of extension is in the range of $40^{\circ}{\sim}50^{\circ}$ and the limit of the normal angle of extension is $70^{\circ}$.

• Physical Therapy Korea
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• v.11 no.4
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• pp.1-6
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• 2004

The kinematics involved in different landing strategies may be related to the occurrence of trauma. Several sources suggest that the angle of knee extension on touchdown and impact with the ground determines the magnitude of the impact force and, indirectly, knee loading. This study compared the initial knee angle and maximum knee flexion angle at the instant of impact on drop-landings between healthy men and women. In this study, 60 participants (30 males, 30 females) dropped from a height of 43 cm. A digital camera and video motion analysis software were used to analyze the kinematic data. When landing, there was significant difference between the two groups ($15.67{\pm}6.05^{\circ}$ in male, $24.10{\pm}6.34^{\circ}$ in female) in the mean knee flexion angle. The range of knee flexion on landing ($44.06{\pm}10.97^{\circ}$ in male, $36.96{\pm}9.99^{\circ}$ in female) also differed significantly (p<.05). The greater knee flexion that was observed in the male subjects would be expected to decrease their risk of injury. Women land with smaller range of knee flexion than men and this might increase the likelihood of a knee injury.

• Journal of Trauma and Injury
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• v.18 no.1
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• pp.26-32
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• 2005

Purpose: We evaluate the characteristics of vertebral body fractures in two level flexion-distraction injuries of the thoracolumbar spine Methods: The findings of radiographs, computed tomographs, and MRIs of 43 patients with flexion-distraction injuries combined with vertebral body fractures were retrospectively evaluated. We divided the patients with bursting fractures into two groups, the distractive group (posterior vertebral height ratio >1) and the compressive group (vertebral height ratio <1). Results: There were 23 compression fractures and 20 bursting fractures. In bursting fractures, the distractive group had 5 cases, and the compressive group 15 cases. In 24 cases (55.8%), the interspinous distances were widened. The average of the canal encroachment was 4% in the distractive group and 40% in the compressive group. At last follow-up, the average loss of correction was 2.0 degree in compression fractures and 2.7 degree in bursting fractures. Conclusion: The configurations of vertebral body fractures in flexion-distraction injuries of the thoracolumbar spine were varied as to the location of the axis of flexion. Because bursting fractures in flexion-distraction injuries had distractive or compressive features, one should consider that in establishing operative plan.

• PNF and Movement
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• v.15 no.2
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• pp.177-183
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• 2017

Purpose: This study compared and analyzed the effect of the proprioceptive neuromuscular facilitation (PNF) arm extension pattern and leg flexion pattern on the contralateral lower extremity muscles when the patterns were applied to the same subject. Methods: In the study, 35 healthy men and women who understood the PNF patterns were selected as participants. The participants completed the PNF arm extension-abduction-internal rotation pattern and leg flexion-adduction-external rotation with knee flexion pattern in the supine position. While the patients' completed each pattern, the contralateral leg muscle activity was measured to examine the irradiation effect. The maximum isometric contraction time of the muscles to be measured was kept for 5 seconds, and the mean value was obtained by repeating the pattern three times. Results: When the leg flexion-adduction-external rotation with knee flexion pattern was completed, the muscle activity in the vastus lateralis, vastus medialis, biceps femoris, tibialis anterior, and gastrocnemius of the contralateral lower extremity was significantly greater than that found in the PNF arm extension-abduction-internal rotation pattern. Conclusion: The PNF leg flexion pattern showed greater muscle activity on the contralateral lower extremity than the arm extension pattern. Thus, the PNF leg extension pattern is more effective in the activation of the muscles associated with weight-bearing activity.