• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.120-124
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• 2016

Objective: Chronic lateral epicondylitis is a condition which becomes sore and tender on the lateral side of the elbow joint damaged from overuse and repetitive use of the extensor muscles of the forearm. The purpose of this study was to investigate the effects of flexion degrees in the elbow joint on extensor carpi radialis longus and brevis and biceps brachii muscles in individuals with healthy young adults. The main purpose of this study was to suggest the feasibility of optimal elbow angle during therapeutic eccentric exercise with resistance for strengthening of wrist extensors. Design: Cross-sectional study. Methods: Thirty health young adults (male 15, female 15) participated in this study. This study measured muscle activation in four different conditions of elbow flexion, $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$ during eccentric exercise with weight loading in wrist extensors, extensor carpi radialis longus and brevis and biceps brachii muscles using surface electromyography. Results: The muscle activation of extensor carpi radialis showed a negative relationship with the degrees of elbow joint flexion. With increasing elbow flexion angles, the ECRL muscle activation amount was significantly lower (p<0.05). In contrast, the muscle activation of the ECRB muscle activation amount was significanlty higher (p<0.05). Conclusions: This study suggests that the eccentric exercise of wrist extension with selected activation of wrist extensor muscles according to elbow flexion positions, and suggests that the extensor carpi radialis longus and brevis will need to be strengthened for preventing and treating chronic lateral epicondylitis regardless of degrees of elbow joint flexion.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.139-146
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• 2016

PURPOSE: The purpose of this study was to determine the effect of craniocervical flexion exercise with masticatory muscle contraction in patients with neck pain. Patients with neck pain also experience muscle weakness and limitation of activities of daily living. Craniocervical flexion exercise with masticatory muscle contraction may increase the thickness of the deep cervical flexor muscles, thereby reducing pain and limitations on activities of daily living. METHODS: Twenty-six volunteers participated in this study. The subjects were randomly divided into an experimental group (n=13) and a control group (n=13). Both groups performed craniocervical flexion exercise using a pressure biofeedback unit; the experimental group performed craniocervical flexion exercise with masticatory muscle contraction for 20 minutes, 3 times a week for 4 weeks. Assessment tools included ultrasonography for measurement of muscle thickness and the Neck Disability Index for the level of pain and function. RESULTS: The rate of change in muscle thickness in both groups significantly increased (p<.05), with a significantly greater increase in the experimental group than in the control group (p<.05). The Neck Disability Index score significantly improved (p<.05) in both groups, with significantly greater improvement in the experimental group compared with the control group (p<.05). CONCLUSION: These results suggest that craniocervical flexion exercise with masticatory muscle contraction can be effective in increasing muscle thickness and improving the Neck Disability Index score in patients with neck pain.

• Korean Journal of Applied Biomechanics
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• v.27 no.2
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• pp.125-132
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• 2017

Objective: The aim of this study was to investigate the effect of targeted knee flexion angle on biomechanical factors of knee joint between upward and downward phases during the forward lunge. Method: Eight elderly subjects (age: $22.23{\pm}1.51years$, weight: $69{\pm}6.63kg$, height: $174.88{\pm}6.85cm$) participated in this study. All reflective marker data and ground reaction force during a forward lunge were collected. The knee joint movement and reaction force and joint moment at maximum knee flexion angle were compared by repeated measures one-way analysis of variance (ANOVA) (p<.05). The peak knee joint reaction force and joint moment between upward and downward phases were compared by repeated measures two-way ANOVA (p<.05). Results: The anterior and vertical knee joint movements, reaction force, and extensor moment of $80^{\circ}$ targeted knee flexion condition at maximum knee flexion angle was greater than both $90^{\circ}$ and $100^{\circ}$ conditions (p<.05). The $80^{\circ}$ knee flexed angle condition had greater peak joint reaction force and extensor moment compared with both $90^{\circ}$ and $100^{\circ}$ conditions between upward and downward phases during the forward lunge. Conclusion: As the targeted knee joint flexion angle increases, knee joint movement and kinetic variables become greater during the forward lunge exercise.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.57-63
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• 2009

Purpose: To better understand falls in elderly women, we measured differences in muscle activities of 4 lower extremity muscles (tibialis anterior, soleus, rectus femoris, biceps femoris) based on angle plantar-flexion in elderly women. Methods: Subjects were 15 healthy elderly women. No subjects had musculoskeletal or nervous disorders. EMGs were used to check muscle activity of lower extremity muscles. For statistic analysis, data were expressed as a percentage of maximal voluntary isometric contraction (%MVIC). We measured %MVIC for 5 sec under 4 conditions and did not use data for the first and last second. Muscle activities of the muscles of the lower extremities were measured based on the degree of plantar-flexion of the ankle joint. The 4 conditions corresponded to different degrees of: 0, 10, 20 and 30 degrees. This was done using a 50 cm board for measuring the degrees. Results: The tibialis anterior, soleus, and bicpes femoris showed increasing muscle activity associated with increasing degree of plantar-flexion of the ankle joint. All muscles showed a significant increase in muscle activities in association with increasing degrees. Rectus femoris showed a significant increase in muscle activity for 0 degrees and for the other degrees, but there were no further changes when plantar flexion of the ankle joint was over 10 degrees. Conclusion: Activities of the muscles of the lower extremities except rectus femoris were higher with increasing degree of plantar flexion. High muscle activity may result in muscle fatigue. Thus, increasing degree of plantar flexion may be risk factors of falls in elderly women.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.36-42
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• 2020

Objective: Many caregivers often carry infants using baby carriers until they are approximately 36 months old. The purpose of this study was to compare the muscular activity of the trunk and lower leg muscles during trunk flexion-extension movements in correspondence to various wearing methods of a baby carrier blanket. Design: Cross-sectional study. Methods: Sixteen healthy adult women were to wear baby carrier blankets in five different ways in terms of direction and height, followed by flexion-extension of the trunk. Erector spinae (ES), rectus abdominis, rectus femoris (RF), biceps femoris (BF) muscle activities and triaxial acceleration of trunk were investigated. Results: The front-wearing method of the baby carrier blanket increased the muscular activity of the ES muscle, and wearing the baby carrier blanket at waist height in the same direction was significantly higher than wearing it at pelvic height (p<0.05). As the angle of flexion increased during trunk flexion-extension, the muscle activity of the ES, BF, and the RF increased. There was a greater increase in muscle activity of the ES and the BF during extension compared to flexion (p<0.05). Conclusions: If it is difficult to wear a baby carrier blanket due to lumbar pain, it is recommended to lower the wearing height of the baby carrier to the pelvic level so that the external load can be transferred to the lower extremity. In addition, it appears to be necessary to hold the baby and distribute the load onto the waist through proper body control when performing flexion-extension movements of the trunk. More objective and scientific research that includes various daily tasks and evaluation methods are needed.

• Journal of Korean Physical Therapy Science
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• v.26 no.2
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• pp.61-73
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• 2019

Purpose: This study was to evaluate the effect of cranio-cervical flexion based trunk stabilization exercise on gross motor function and posture alignment change in children with spastic cerebral palsy. Design: Randomized Controlled Trial. Methods: Twenty-six children participated in this study. All subjects were randomly assigned to either the Cranio-Cervical Flexion Based Trunk Stabilization Exercise (CCFTS) group (n=13) or the Trunk Stabilization Exercise (TS) group (n=13). In both groups were trained general physical therapy for 10 minutes, in the CCFTS group was trained cranio-cervical flexion based trunk stabilization exercise for 20 minutes and in the TS group was trained trunk stabilization exercise for 20 minutes. The training was provided 2 times a week during 8 weeks. All subjects were measured with the Gross Motor Function Measure (GMFM) and Cranio-Vertebral Angle (CVA) before and after intervention. Results: The results showed that the CCFTS have increased significantly in GMFM (B, C, D and E-dimension) and CVA, and the TS group have increased significantly in GMFM (B, C D and E-dimension). In particular, the CCFTS group improved significantly than TS group in GMFM (B, C and D-dimension) and CVA. Therefore, the cranio-cervical flexion based trunk stabilization exercise improved gross motor function and posture alignment in children with spastic cerebral palsy. Conclusion: These results suggest that cranio-cervical flexion based trunk stabilization exercise is feasible and suitable for individuals with a spastic cerebral palsy and can be used in addition to conventional physical therapy.

• PNF and Movement
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• v.16 no.3
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• pp.333-343
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• 2018

Purpose: The purpose of this study was to investigate the effects of a neck exercise using a proprioceptive neuromuscular facilitation (PNF) neck flexion and extension pattern on body balance in a progressive range of positions (supine, prone on elbow, and sitting), on numbness in the upper extremities, and on neck flexion motions in cervical myelopathy patients. Methods: One participant who was diagnosed with cervical myelopathy participated in this study. A reversal design (A-B-A') was used. The A and A' were the baseline period (no intervention), and B was the intervention period. The intervention used a neck extension pattern with a hold-relax technique and a neck flexion pattern with a combination of isotonic techniques in the supine position. Then, neck flexion and extension patterns were applied together with a reversal technique for stabilization, followed by a neck extension pattern with a combination of isotonic techniques in the prone position on the elbows. Finally, a neck flexion and extension pattern was used with a stabilizing reversal technique, and a neck extension pattern was applied with a combination of isotonic techniques in the sitting position for 60 minutes per day, 3 times per week for 8 weeks. To measure balance, numbness, and neck motion during neck flexion, the one-leg stand test and the visual analogue scale were used. Results: The right and left one-leg stand tests showed increased balance ability in the intervention phase. Upper extremity numbness was decreased in the intervention phase, and neck flexion motion was increased in the intervention phase. These increases were maintained after the intervention (Baseline II). Conclusion: These results suggest that a neck exercise using a PNF neck pattern with additional techniques in a progressive range of positions has a positive effect on cervical myelopathy patients for balance, numbness, and neck motion.

• PNF and Movement
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• v.10 no.1
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• pp.9-17
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• 2012

Purpose : This study's purpose is consideration about change of the hand grip strength according to different posture and shoulder flexion angle. The shoulder joint permits the greatest mobility and carries out the important function of stabilization for hand use. Hand grip activity is important to evaluate while assessing loads of shoulder in hand mobilities. Methods : Thirty(15 male, 15 female) college students with unknown shoulder dysfunction participated subject in five different positions of elbow extension with sitting and standing posture, different positions is followed : (1) shoulder $0^{\circ}$ flexion (2) shoulder $45^{\circ}$ flexion (3) shoulder $90^{\circ}$ flexion (4) shoulder $135^{\circ}$ flexion (5) shoulder $180^{\circ}$ flexion. Results : On the average, in the hand grip strength, the standing posture is higher than sitting posture. Sitting posture showed a most high level at the man's $0^{\circ}$ and woman's $135^{\circ}$. And standing posture showed a most high level at the man's $135^{\circ}$ and woman's $90^{\circ}$. Conclusion : The paired t-test was used to determine the different in grip strength between sitting and standing posture by shoulder angle change. There was no significant difference between the five position by sitting and standing posture. In man, correlation analysis revealed significant connection for all five position by sitting and standing posture. And in woman, correlation analysis revealed connection for all five position by sitting and standing posture.

• Physical Therapy Korea
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• v.29 no.2
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• pp.165-170
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• 2022

Background: The serratus anterior (SA) muscle prevents scapular winging (SW) by stabilizing the medial border of the scapula during arm movement. The upper trapezius (UT) and lower trapezius (LT) muscles may compensate for the weak SA muscle in individuals with SW during shoulder flexion. However, there is no study to examine whether compensation by UT and LT occurs in individuals with SW. Objects: This study compared the muscle activities of UT, LT, and SA as well as the SA/UT activity ratio between individuals with and without SW during shoulder flexion with load. Methods: This study recruited 27 participants with SW (n = 14) and without SW (n = 13). Electromyography data of the SA, UT, and LT muscles and SA/UT activity ratio were recorded and analyzed during shoulder flexion with 25% load of the maximal shoulder flexion force. Independent t-test was used to compare the UT, LT, and SA muscle activities and SA/UT ratio between the groups with and without SW; statistical significance was set at α of 0.05. Results: SA activity was significantly lesser in the group with SW than in the group without SW. However, there were no significant differences in the UT and LT activities and SA/UT activity ratio between the two groups. Conclusion: The SA activity was lesser in the group with SW than in the group without SW with 25% load of the maximal shoulder flexion force, but there was no compensatory muscle activity of the UT and LT observed. Therefore, further studies are warranted to clarify the compensatory strategy of scapular stabilization in individuals with SW during shoulder flexion under other heavy load conditions.

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.4
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• pp.679-690
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• 2017

The purpose of this study was to investigate the relationship between neck posture and range of motion and neck disability index(NDI) in young adults with reduced cervical lordosis. This study selected 34 young adults with cervical lordosis reduced (Cobb's angle less than 35 degrees). The assessor measured neck flexion, extension, left lateral flexion, right lateral flexion, left rotation, right rotation and forward displacements of all subjects using cervical of range motion instrument, Then, the NDI was evaluated. After all assessments, degree for cervical lordosis was divided into two groups: bottom group(severe cervical lordosis) and top group(mild cervical lordosis). The bottom group was significantly higher in Cobb's angle, extension, left lateral flexion, right lateral flexion, left rotation, right rotation and forward displacement compared to the top group (p<.05). There was no significant difference between the two groups in flexion, NDI(p >.05). In comparison of subscale of NDI, top group was significantly higher in pain, lifting, and headache than bottom group (p <.05). In correlation analysis, Cobb's angle showed significant positive correlation with flexion, extension, left lateral flexion, right lateral flexion, left rotation and right rotation(p<.05), and showed significant negative correlation with forward displacement, NDI(p<.05). Cobb's angle showed a significant negative correlation with pain, lifting, and headache of subscale of NDI(p<.05). The findings of this study potentially suggest that neck posture may affect the cervical range of motion and pain.