• Physical Therapy Rehabilitation Science
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• 제6권1호
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• pp.7-13
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• 2017

Objective: The aim of this study was to investigate the inter-rater and intra-rater reliability of rehabilitative ultrasound imaging (RUSI) for measurement of muscle thickness with changes in angles of the gluteus maximus (GM) at rest and during contraction. Design: Cross-sectional study. Methods: Twenty-two healthy men volunteered for this study. GM muscle images were obtained in the resting position and during prone hip extension with knee flexion at hip abduction angles of $0^{\circ}$ and $30^{\circ}$, respectively. Two examiners randomly measured the thickness of the GM twice in three different positions. The first position was a comfortable prone position. The second position was prone hip extension with knee flexion (PHEKF) to $90^{\circ}$. The third position was achieved by hanging a 1-kg weight on the ankle of the lifted leg during PHEKF with the angle of the lifted leg the same as the second position. Intra-class correlation coefficients (ICCs), standard error measurements, and minimal detectable changes were used to estimate reliability. Results: The intra-rater reliability ICCs (95% confidence interval) of the GM were >0.870, indicating good reliability. Inter-rater reliability ICCs ranged from 0.668 to 0.913. The reliability of measurements of muscle thickness at each position was similar to the reliability of the angle change. Differences in muscle thickness and ratios for each position with $0^{\circ}$ and $30^{\circ}$ of hip abduction were not statistically significant. Conclusions: In the present study, the intra-rater reliability of muscle thickness measurements of the GM was good, and the inter-rater reliability was moderate to good. Reliable RUSI measurements of wide and large muscles, such as the GM muscle at rest and during contraction, are feasible. Further investigation is required to establish the reproducibility of the protocols presented in this study.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.244-250
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• 2021

Objective: The purpose of this study was to investigate the effect of sprinter pattern bridging exercise using theraband on activation of lower extremity and abdominal muscle and to find out postures that can effectively improve abdominal and lower extremity muscle strength and increase abdominal stability. Methods: This study was designed as a cross-sectional study. The following research was done with applicants attending S university in Seoul to compare the difference in muscle activity between one-leg-Support bridging exercise and sprinter-pattern bridging exercise using theraband. For 48 study participants, we first measured their MVC. Then, we applied one-leg-support bridging exercise and sprinter-pattern bridging exercise at random order. These data were expressed as the percentage of maximal voluntary contraction (%MVC).Electromyography analysis was performed by measuring the external obliques, internal obliques, biceps femoris, and gluteus maximus. Results: There was a statistically significant increment of muscle activity in external and internal oblique muscle(p<0.001)by sprinter-pattern bridging exercise using theraband. On the lower body, statistically significant increment of muscle activity in biceps femoris and gluteus maximus was found(p<0.05). On the other hand, on erector spinae, there was statistically significant decrease in muscle activity(p<0.05). Conclusions: Efficient treatment is expected when sprinter-pattern bridging exercise using theraband is applied clinically.For patients with chronic knee and ankle pain who have difficulty bearing weight, including low back pain and internal rotation of the femur, starting with a low weight bearing, we think it will be helpful in planning systematic training aimed at progressively strengthening the lower extremities.

• 대한물리의학회지
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• 제14권3호
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• pp.29-37
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• 2019

PURPOSE: Prone hip extension (PHE) has been used for assessment of lumbo-pelvic movement and strengthening exercise for weakness of the hip joint muscles in patients with chronic low back pain (CLBP). On the other hand, few studies have examined which are the best PHE exercises to activate the gluteus maximus (GM) selectively in physical therapy practice. To aim of this study compared the muscle activity of the GM, rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) during these four different prone hip extensions, PHE, PHE with quadriceps activation (PHEQA), PHE with ankle dorsiflexion (PHEAD), and PHE with ankle plantarflexion (PHEAP), in subjects with CLBP. METHODS: Nineteen subjects with low back pain participated in this study. Subject performed four PHE exercises and surface electromyography (EMG) was used to evaluate the muscle activity. Data were analyzed by one-way repeated-measures analysis of variance (${\alpha}=.05/3=.017$) and a Bonferroni adjustment was performed if a significant difference was found. RESULTS: The muscle activities recorded by EMG showed significant among the four exercises. The muscle activity of the GM increased significantly during PHEQA than during PHEAP (P=.012). CONCLUSION: PHEQA is the most effective exercise for eliciting greater GM muscle activation among the four PHE exercises in subjects with CLBP.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.455-461
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• 2019

Background Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based fasciocutaneous flap and a muscle flap is expected to resolve the disadvantages of previously introduced surgical methods. Methods Fifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) fasciocutaneous flap and a split inferior gluteus maximus muscle flap from January 2011 to June 2016, were analyzed retrospectively. The split muscle flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP fasciocutaneous flap was rotated or advanced to cover the superficial layer. The patients' age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed. Results All ischial pressure ulcers were successfully reconstructed without any flap loss. The mean duration of follow-up was 12.9 months (range, 3-35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated fasciocutaneous flap. Conclusions The dual-flap procedure with an IGAP fasciocutaneous flap and split inferior gluteus maximus muscle flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and muscle flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury.

• 대한통합의학회지
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• 제9권1호
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• pp.133-140
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• 2021

Purpose: This study aimed to compare the relative muscle activity on the erector spinae, gluteus maximus, and hamstring, using a non-visual feedback bridge exercise and a visual feedback bridge exercise with a tension sensor and clinometer. Methods: Twenty-two healthy subjects participated in this study. The study subjects performed bridge exercises without visual feedback, bridge exercises using a tension sensor, and bridge exercises using an inclinometer in the supine position, and the muscle activity of the left and right erector spinae, gluteus maximus, and hamstring muscles was measured while maintaining isometric contraction during the bridge movement. Muscle activity was measured by using surface an electromyography equipment. To standardize the measured action potential of each muscle, the maximum voluntary isometric contraction was measured. The bridge exercise was repeated 3 times for 5s each. Using repeated analysis of variance, we compared the significant difference in EMG activity for each muscle between the three experiments, and all statistical processing was performed using SPSS version 26. The statistical significance level was set at α = 0.05. Results: During bridging exercises, the asymmetry of the muscle activity of the erector spinae and gluteus maximus during visual feedback guiding was lower than that during no visual feedback. However, there was no significant difference. Moreover, the asymmetry of the muscle activity of the hamstring muscles was significantly lower during tension sensor visual feedback than that during no visual feedback (p<0.05). Conclusion: These findings suggest that bridge exercise with visual feedback using a tension sensor and an inclinometer is effective in inducing symmetrical movement. When it is necessary to symmetrically adjust the weight load of both feet during the bridge exercise, it is effective to apply visual feedback using a tension sensor.

• 한국전문물리치료학회지
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• 제29권1호
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• pp.11-18
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• 2022

Background: Muscle activities of gluteus maximus (GM) and hamstring (HAM) have important roles in the stability and mobility of the hip joint during various functional activities including bridge and prone hip extension exercises. Objects: The purpose of this study is to investigate muscle activities of GM, multifidus (MF) and HAM during three different bridge exercises in healthy individuals. Methods: Twenty healthy subjects were participated. Electromyography device was used to measure muscle activities of GM, MF and HAM. Each subject was asked to perform three different bridge exercises with hip abduction (0°, 15°, 30°) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Statistical significance was set at α = 0.01. Results: The muscle activity of GM was significantly different among three conditions (hip abduction 0°, 15°, 30°) (adjusted p-value [Padj] < 0.01). The muscle activity of GM was significantly greater during bridge exercise with hip abduction 30° compared to 0° and 15° (Padj < 0.01). There was no significant difference in the muscle activity of MF and HAM muscle (Padj > 0.01). The ratio of muscle activity (ratio = GM/HAM) during bridge exercise with hip abduction 30° was significant greater compared to the hip abduction angles 0° and 15° (Padj < 0.01). Conclusion: Bridge exercise with hip abduction 30° can be recommended to selectively facilitate the muscle activity of GM and improve the ratio of muscle activity between GM and HAM.

• The Journal of Korean Physical Therapy
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• 제35권1호
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• pp.13-18
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• 2023

Purpose: The purpose of this study was to investigate the effects of posterior oblique sling activation on the muscle activities of the gluteus maximus (GM), multifidus (MF), and biceps femoris (BF) during three different prone hip extension exercises in healthy male individuals. Methods: Twenty healthy subjects participated in this study. An electromyography device was used to measure the muscle activities of the GM, MF, and BF. Each subject was asked to perform three different prone hip extensions as follows: [1) Prone hip extension with knee flexion + hip abduction 30°; PHE1, 2) Prone hip extension with knee flexion + hip abduction 30° and shoulder abduction 125°; PHE2, 3) Prone hip extension with knee flexion + hip abduction 30° and shoulder abduction 125° with 1kg loading; PHE3, in random order. A one-way repeated measures analysis of the variance and a Bonferroni post hoc test were used to analyze the results. The statistical significance was set at α=0.01. Results: The muscle activity of the GM was significantly different between the three positions (P_adj<0.01). The muscle activity of the GM was significantly greater during PHE3 compared with PHE1 and PHE2 (P_adj<0.01). The BF muscle activity was significantly lower during PHE3 compared with PHE1 and PHE2 (P_adj< 0.01). There was no significant difference in the muscle activity of the MF (P_adj<0.01). The ratio of the muscle activity (ratio=GM/BF) during PHE3 was significantly greater compared to PHE1 and PHE2 (P_adj< 0.01). Conclusion: The GM activity and GM/BF ratio during the PHE3 exercise were significantly greater compared to that during PHE1 and PHE2. Therefore, the PHE3 exercise could be recommended as a selectively effective GM activation exercise while decreasing the muscle activity of the BF.

• Physical Therapy Rehabilitation Science
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• 제12권1호
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• pp.26-32
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• 2023

Objective: This study attempted to compare the effects of bridge exercise using a sling according to the angle of the ankle to confirm the effective lower extremity muscle activation posture of patients with patellofemoral pain syndrome(PFPS). Design: Cross-sectional study Methods: Seventeen patients with PFPS were recruited and the muscle activities of the vastus medialis, vastus lateralis, rectus femoris, and gluteus maximus were measured according to the ankle position (dorsiflexion, neutral, plantar flexion). After measuring the maximum number of isometric contractions of vastus medialis, vastus lateralis, rectus femoris, and gluteus maximus, bridging exercise using a sling according to each ankle posture was applied to measure lower extremity muscle activity. The evaluation was performed 3 times for 10 seconds. The three ankle postures were randomly performed and the average values were compared. Results: As a result of this study, the vastus medialis muscle showed high muscle activity in the order of dorsiflexion, plantar flexion, and neutral position bridge exercise (p<0.05). And the vastus lateralis showed high muscle activity in the order of dorsiflexion, neutral, and plantar flexion (p<0.05). However, rectus femoris and gluteus maximus did not show significant muscle activity according to the ankle posture, but muscle activity was highest in the dorsiflexion posture. Conclusions: As a result of this study, muscle activity was high in the order of vastus medialis and vastus lateralis during ankle dorsiflexion. This is thought to be a major factor that can be applied in various ways in clinical practice according to the ankle angle when treating PFPS patients.

• PNF and Movement
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• 제21권3호
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• pp.309-317
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• 2023

Purpose: This study set out to investigate the effects of prone hip extension with knee flexion (PHEKF) exercises according to external load on the thickness of the gluteus maximus (Gmax) and biceps femoris (BF). Methods: Twenty-three healthy men participated in this study. All subjects randomly practiced PHEKF under the burden of external loads created by sandbags (0 kg, 1 kg, and 2 kg). Rehabilitative ultrasound imaging (RUSI) was used to measure the thickness of the Gmax and BF during the PHEKF with different external loads. Results: The thickness of the Gmax was highest during the 2 kg resistance exercise and lowest at 0 kg. The thickness of the Gmax was significantly increased at 1 kg and 2 kg compared to 0 kg and significantly increased at from 1 kg to 2 kg (p < 0.05). The thickness of the biceps femoris was highest at 0 kg and lowest at 2 kg. The thickness of the biceps femoris muscle was significantly reduced at 1 kg and 2 kg compared to 0 kg (p < 0.05), but there was no significant difference between 1 kg and 2 kg (p > 0.05). Conclusion: The thickness of the Gmax was increased by applying PHEKF with a higher external load, whereas the muscle thickness of the biceps femoris decreased. These results suggest that the application of external loads during PHEKF exercises may be an effective method for selective strengthening of the Gmax.

• 한국전문물리치료학회지
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• 제19권2호
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• pp.1-11
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• 2012

The pelvic compression belt (PCB) contributes to improving sacroiliac joint stability, and it has been used as an additional therapeutic option for patients with sacroiliac joint pain (SIJP). This study aimed to investigate whether the muscle activation patterns of the supporting leg was different between asymptomatic subjects and subjects with SIJP during one-leg standing, and how it changes with the PCB. 15 subjects with SIJP and 10 asymptomatic subjects volunteered to participate in this study. Surface electromyography (EMG) data (reaction time [RT] and muscle activation) were collected from the internal oblique, lumbar multifidius, gluteus maximus and biceps femoris muscles during one-leg standing with and without the PCB. Without the PCB condition, in the SIJP group, the biceps femoris muscle showed the fastest RT among all muscles (p<.05), whereas in the asymptomatic group, the RT of the internal oblique muscle was the most rapid (p<.05). In condition without the PCB, the biceps femoris EMG amplitudes in the SIJP group were significantly greater than that in the asymptomatic group (p<.05). After the application of the PCB, the RT of the biceps femoris muscle was significantly increased only in the SIJP group (p<.05). Moreover, the biceps femoris EMG amplitudes significantly decreased and the gluteus maximus EMG amplitudes significant increased only in the SIJP group by applying the PCB (p<.05). However, this had no such effect on the gluteus maximus and biceps femoris EMG patterns in the asymptomatic group (p>.05). Thus, this study supports the applying the PCB to patients with SIJP can be used as a helpful option to modify the activation patterns of the gluteus maximus and biceps femoris muscle.