• The Journal of Korean Physical Therapy
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• 제15권1호
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• pp.155-170
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• 2003

Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. There in evidence of muscle dysfunction related to the control of the movement system. There is a clear link between reduced proprioceptive input, altered slow motor unit recruitment and the development of chronic pain states. Dysfunction in the global and local muscle systems in presented to support the development of a system of classification of muscle function and development of dysfunction related to musculoskeletal pain. The global muscles control range of movement and alignment, and evidence of dysfunction is presented in terms of imbalance in recruitment and length between the global stability muscles and the global mobility muscles. The local stability muscles demonstrate evidence of failure of aeequate segmental control in terms of allowing excessive uncontrolled translation or specific loss of cross-sectional area at the site of pathology Motor recruitment deficits present as altered timing and patterns of recruitment. The evidence of local and global dysfunction allows the development of an integrated model of movement dysfunction. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model in proposed and evidence for the efficacy of the approach provided.

• 대한정형도수물리치료학회지
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• 제26권1호
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• pp.27-36
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• 2020

Background: Exercise in the quadruped position is performed to improve body and shoulder stability. This study examined the muscle activity of the trunk muscles according to the distance of the weight shift when lifting one leg in the quadruped position. Methods: Ten healthy 20 to 40 years old males were tested as subjects. All subjects moved their body weight to 0, 5, and 10cm on the opposite side of the leg lifter while maintaining the quadruped position. The surface electrodes recorded the electromyography data during the one leg lifting. Results: As the weight shift distance was increased, there was a significant difference in muscle activity of both serratus anterior, multifidus and internal oblique muscles (p<.05). Left and right serratus anterior and right internal oblique were most activated when weight shift distance was 0cm (p<.05). Conclusion: Shoulder and lumbar stabilization exercises should be applied in the absence of a weight shift distance during quadruped exercise.

• The Journal of Korean Physical Therapy
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• 제24권5호
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• pp.300-305
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• 2012

Purpose: This study examined the muscle activity of the trunk muscles during weight shifting exercises on a stable and unstable surface. Methods: Ten healthy young subjects (4 males, 6 females) with no medical history of lower-extremity or lumbar spine disease were enrolled in this study. The muscle activity was recorded using surface electromyography (EMG) electrodes from the both sides of the external obliques and erector spinae muscles. Results: The EMG activities of the both rectus abdominalis, both external obliques and erector spinae muscles were significantly higher when the weight shifting exercise was performed on a firm surface than when a balance pad with a balance ball was used. In weight shifting exercises, the EMG activity of the contralateral external obliques and erector spinae muscles was significantly higher than that of the ipsilateral external obliques and erector spinae muscles under all three support surface conditions. Conclusion: Performing weight shifting exercise using an unstable surface is a useful method for facilitating the trunk-muscle strength and trunk stability.

• 대한물리의학회지
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• 제8권4호
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• pp.609-617
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• 2013

PURPOSE: This study aims to provide effects of therapeutic techniques as well as basic materials of safety by comparing and analyzing the effects of hamstring flexibility and dynamic stability of lower lumbar according to Stretching and Massage Techniques to adults with reduced the flexibility of hamstring. METHODS: This study conducted differential diagnosis through sit and reach test(SRT) and Schober test to select subjects who have shortened hamstring without any spinal problem. Selected subjects were divided into two groups randomly; HSG(Hamstring Stretching Group, n=8) and HMG(Hamstring Massage Group, n=8) and they received treatment for 2 weeks. To take statistics, SRT and dynamic view using x-ray were used. RESULTS: On SRT, HSG and HMG showed significant difference between pre and post test. A comparison of the difference value between HSG and HMG, HSG($9.73{\pm}1.78$) has more remarkable outcome than HMG($2.78{\pm}0.56$). Lower lumbar intervertebral disc length test for Intervertebral disc length(IDL)L45 and IDLL5S1 did not show significant differences between two groups and difference value. CONCLUSION: This study showed that stretching is more effective to improve hamstring flexibility than massage technique. Especially, flexibility increase of the hamstring in vertebral stabilization cannot affect improvement possibility will make a flexibility in order and the intervention and stabilization exercise of the spine.

• 재활복지공학회논문지
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• 제11권3호
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• pp.207-214
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• 2017

몸통안정성에 문제가 발생하면 허리에 통증이 발생된다. 허리 불안정성을 해소하기 위한 몸통안정화운동 방법 중 하나인 복부드로우인기법(ADIM)은 복부안정화근육 중 선행적자세조절과 관련된 배가로근에 대한 선택적인 수축을 유도하는 운동법이다. ADIM은 일반적으로 바로누운자세에서 허리 밑에 압력생체되먹임장치(PBU)을 적용하여 시각적되먹임을 한 상태에서 실시하는데 이러한 자세는 앉은자세에 비해 기능적이지 못하다. 본 연구에서는 바로누운자세와 앉은자세에서 실시하는 ADIM의 효과를 알아보기 위해 31명의 건강한 남녀를 대상으로 무선 근전도를 이용해 배곧은근(RA), 배바깥빗근(EO), 배가로근/배속빗근(TrA/IO), 그리고 척추세움근(ES)에 대한 근활성도를 비교하였다. 본 연구 결과 RA와 EO에서는 두 자세 간에 유의한 차이가 없었으며 TrA/IO와 ES에서는 두 자세 간에 유의한 차이가 나타났다. 또 RA에 비해 TrA/IO의 활성도가 높게 나타나 ADIM로 인한 몸통안정화는 두 자세 모두에서 효과적으로 나타났으며 반면 TrA/IO와 ES는 앉은 자세에서 더 높은 활성도를 보여 자세 안정화 근육의 활성도가 앉은 자세에서 더 증가한 것으로 사료된다. 따라서 일상생활에서 보다 쉽게 적용할 수 있는 앉은 자세의 ADIM은 허리안정성 향상에 유용할 것이다.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.16-25
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• 2010

The aim of this study was to determine the muscle activity of the abdominalis and erector spinae during bridging and unilateral bridging exercises on the firm surface, the sir-fit, and the foam roll. Eighteen healthy young subjects were recruited for this study. Surface electromyographic (EMG) activities were recorded from the both sides of the rectus abdominalis, external obliques, internal obliques, and erector spinae muscles during bridging and unilateral bridging-exercises. A one-way repeated analysis of variance was used to compare the EMG activity of each muscle according to the support surface condition. Differences in the EMG activities between the bridging and unilateral bridging exercises, and between the right and left side were assessed using a paired t-test. The study showed that the EMG activities of all of the muscles were significantly higher when the bridging exercise was performed using the foam roll or sit-fit than on the firm surface. The EMG activities of the right rectus abdominis, right external obliques, the right internal oblique, and both erector spinae were significantly higher during unilateral bridging ex exercise using the foam roll or the sit-fit than on the firm surface. The EMG activities of all of the muscles were significantly higher during the unilateral bridging exercise than during the bridging exercise. Based on these finding, performing the unilateral bridging exercise using the sit-fit or the foam roll is a useful method for facilitating trunk muscle strength and lumbar stability.

• 국제물리치료학회지
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• 제4권2호
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• pp.573-587
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• 2013

The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

• The Journal of Korean Physical Therapy
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• 제33권5호
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• pp.238-244
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• 2021

Purpose: Menstruation is associated with menstrual symptoms like pain and balance problems which have an impact on the quality of life. Pilates increases pelvic stability and reduces menstrual pain by inducing abdominal muscle contraction. This study was done to evaluate the effects of Pilates on menstrual pain, symptoms, balance, and quality of life when compared to aerobic exercise. Methods: Thirty-nine women with menstrual pain were randomly divided into the Pilates group (n=13), aerobics group (n=13), and control group (n=13). The Pilates group performed lumbar-pelvic stabilization exercises, while the aerobic group ran on a treadmill. The control group did not undergo any intervention. The experimental groups exercised for four weeks (12 sessions) and did not exercise during menstruation. The Y-balance test was performed on the second day of menstruation to evaluate dynamic balance. The questionnaires administered immediately after menstruation were the visual analog scale (VAS), Korea Oswestry Disability Index (ODI), and the modified Menstrual Distress Questionnaire (MDQ). The paired t-test was used to compare the effect of exercise within the three groups and a oneway analysis of variance was used to compare between groups. Results: VAS and MEDI-Q scores significantly decreased in the Pilates group after 4 weeks compared with those in the aerobic and control groups. Moreover, ODI and Y-balance scores increased in the Pilates group compared with those in the aerobic and control groups (p<0.05). Conclusion: The Pilates stabilization exercises are effective and help in improving menstrual pain, balance and other menstrual symptoms assessed through ODI, and MEDI-Q, compared to aerobic exercises.

• 한국전문물리치료학회지
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• 제19권1호
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• pp.19-27
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• 2012

The purpose of this study was to determine the effect of contralateral hip adduction (CHA) on thickness of lumbar stabilizers during hip abduction in side-lying. Twenty healthy subjects without back pain were recruited for this study. The thickness of transverse abdominis (TrA), internal oblique (IO) and quadratus lumborum (QL) were measured by ultrasonography. Pelvic lateral tilting motion was measured using a three-dimensional motion analysis system. Measurements were performed at rest position (RP), $35^{\circ}$preferred hip abduction (PHA) and $35^{\circ}$abduction with $10^{\circ}$contralateral hip adduction (CHA) in side-lying at the end of expiration. During the measurements, subjects were asked to maintain steady trunk alignment without hand support. Thickness of TrA and IO was significantly greater in CHA than in PHA and RP conditions. There was no significant difference in thickness of TrA and IO between PHA and RP conditions. Medio-lateral (M-L) thickness of QL was not significant between PHA and CHA conditions. Anterio-posterior (A-P) thickness of QL in PHA and CHA significantly decreased compared to RP condition. Angle of pelvic lateral tilting was significantly decreased in CHA compared to PHA condition. In conclusion, CHA can be recommended for increasing trunk stability without compensatory pelvic motion during hip abduction exercise in side-lying.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.1-7
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• 2014

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.