• 대한물리치료과학회지
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• 제6권3호
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• pp.25-40
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• 1999

The hub of weight bearing in the human body for both static and dynamic activities is the lumbopelvic region. It is a key region of extraordinary stability, since the trunk and ground forces converage in this region. The two sacroiliac joints form an integral part of this lumbopelvic unit. Considerable effort has been expended to study and quantify the normal range of movement of the sacroiliac joints Mitchell suggests that the ilium rotates in a posterior direction at heel strike and progresses in an anterior direction as the individual passes through the stance phase. The overall key appears to lie in determining the weight-bearing pattern of the sacroiliac (lumbopelvic) region from above and below that results in the familiar pain of sacroiliac dysfunction, assessing the status of the injured tissues, and intervening with the proper treatment protocols that maximize the body's healing processes. The purpose of this chapter is to provide a comprehensive overview of the sacroiliac joint's tissues and biomechanics, as well as concepts of evaluation and treatment. This overview is aimed at assisting the clinician in identifying the forces that are potentially destructive to the lumbopelvic tissues.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.49-55
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• 2014

Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.

• 대한정형도수물리치료학회지
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• 제4권1호
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• pp.7-20
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• 1998

Activity of the trunk muscles is essential for maintaining stability of the lumbar spine because of the unstable structure of that portion of the spine. The central nervous system deals with stabilization of the spine by contraction of the abdominal and multifidus muscles in anticipations of reactive forces produced by limb movement. Recent evidence indicates that the lumbar multifidus muscle and transversus abdominis muscle may be involved in controlling spinal stability. Stabilization training in neutral spine is an integrated approach of education in proper posture and body mechanics along with exercise to improve strength, flexibility, muscular and cardiovascular endurance, and coordination of movement.

• The Journal of Korean Physical Therapy
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• 제25권5호
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• pp.337-342
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• 2013

Purpose: This study was conducted in order to determine the effect of visual and tactile feedback on muscle activity of the gluteus maximus (Gmax) and abdominal muscles and the motion of pelvic rotation during performance of clam exercise (CE). Methods: Thirteen subjects without low back pain were recruited for this study. Each subject was instructed to perform the CE without and with feedback. The subjects were instructed to keep pelvic from rotating backwards by palpating the ASIS and monitoring the pelvic movement by themselves during performance of CE with feedback. The electromyographic (EMG) activities of Gmax and abdominal muscles were collected using surface EMG. Angles of pelvic rotation were measured using a 3-dimensional motion-analysis system. Paired t-tests were used for comparison of EMG activities in each muscle and the angle of pelvic rotation. Results: The EMG activities of all abdominal muscles were not significant between CM without and CM with feedback (p>0.05). The EMG activity of Gmax was significantly greater in CM with feedback compared with CM without feedback (without vs. with feedback; 14.2% vs. 20.7%MVIC) (p<0.05). The angle of pelvic rotation was significantly less in CM with feedback compared with CM without feedback (without vs. with feedback; $15.3^{\circ}$ vs. $10.8^{\circ}$ ) (p<0.05). Conclusion: Therefore, these findings suggest that CM with the visual and tactile feedback is effective in activation of the Gmax and correcting of the uncontrolled lumbopelvic rotation during CE.

• The Journal of Korean Physical Therapy
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• 제32권4호
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• pp.228-232
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• 2020

Purpose: This study examined the electromyography (EMG) activity of the abdominal muscles and the ratio of the oblique abdominal muscle activity to the rectus abdominis muscle during a single-leg holding position with isometric shoulder abduction (SLHISA) in the supine position on a foam roller. Methods: Nineteen healthy males were recruited to the study. Each subject was asked to lay on a round foam roller and perform singleleg (nondominant) holding with contralateral shoulder abduction to one of three angles (45°, 90°, or 135°) in random order. The surface EMG signals of the bilateral rectus abdominis (RA), external oblique abdominis (EO), and combined internal oblique abdominis (IO) and transverse abdominis (TrA) muscle were collected during the tasks. The EO/RA and (IO & TrA)/RA ratios were determined using surface EMG. One way repeated measure ANOVA with three SLHISAs was used to assess the significant abdominal muscle EMG activity and the ratio of the oblique abdominal muscles activity to the RA muscle. The statistical significance level was p<0.05. Results: The results were as follows. The SLHISA 135° showed significantly higher EMG activity of both RAs, left EO, and right IO & TrA muscles (p<0.05). The right EO and left IO and TrA muscles/RA were significantly different among the SLHISA angles. The SLHISA 45° showed a significantly greater ratio of right EO/RA and left IO & TrA/RA (p<0.05). Conclusion: SLHISA on a foam roller is useful for lumbopelvic stabilization exercise by increasing the activity and recruiting a specific pattern of the oblique abdominal muscle.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.87-92
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• 2020

Background: Bridging exercises are used to enhance the functional stability of the lumbopelvic region in clinical settings. Although most of the studies on bridging exercises have compared the complete activation of the trunk muscles, some recent studies have examined the functional stability of the trunk and the lumbopelvic region and assessed the appropriate recruitment of the local and global muscles during different task levels. Objects: The purpose of this study was to investigate the changes in muscle thickness in the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles during a common bridging exercise on an unstable surface and to determine whether these changes differ based on the surface used. Methods: Twenty-five healthy young adults (8 males, 17 females) were recruited. The subjects were randomly assigned to either the exercise progression with a sling bridge group or the ball bridging exercise progression group, each with three stages of increasing difficulty. Each position was measured three times with an ultrasonic diagnostic imaging system, and the mean values were recorded for analysis. Results: No significant differences were observed between the TrA, IO, or EO muscle thickness ratios between the sling and ball exercise groups (p > 0.05). There were also no significant differences in the EO muscle thickness ratios between the tasks irrespective of whether the sling or ball was used. However, the TrA and IO thickness ratios in both groups were significantly greater during stages 2 and 3 compared to stage 1. Conclusion: The results suggest that the use of slings and balls during bridging exercises is effective in activating the deep abdominal muscles.

• 한국전문물리치료학회지
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• 제26권4호
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• pp.1-9
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• 2019

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, $24.0{\pm}5.0$ years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.144-151
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• 2023

Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.

• 한국전문물리치료학회지
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• 제26권2호
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• pp.16-23
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• 2019

Background: High-heeled shoes can change spinal alignment and feet movement, which leads to muscle fatigue and discomfort in lumbopelvic region, legs, and feet while walking. Objects: This study aimed to identify the effects of different shoe heel heights on the walking velocity and electromyographic (EMG) activities of the lower leg muscles during short- and long-distance walking in young females. Methods: Fifteen young females were recruited in this study. The experiments were performed with the following two different shoe heel heights: 0 cm and 7 cm. All participants underwent an electromyographic procedure to measure the activities and fatigue levels of the tibialis anterior (TA), medial gastrocnemius (MG), rectus femoris (RF), and hamstring muscles with each heel height during both short- and long-distance walking. The walking velocities were measured using the short-distance (10-m walk) and long-distance (6-min walk) walking tests. Results: Significant interaction effects were found between heel height and walking distance conditions for the EMG activities and fatigue levels of TA and MG muscles, and walking velocity (p<.05). The walking velocity and activities of the TA, MG, and RF muscles appeared to be significantly different between the 0 cm and 7 cm heel heights during both short- and long-distance walking (p<.05). Significant difference in the fatigue level of the MG muscle were found between the 0 cm and 7 cm heel heights during long-distance walking. In addition, walking velocity and the fatigue level of the MG muscle at the 7 cm heel height revealed significant differences in the comparison of short- and long-distance walking (p<.05). Conclusion: These findings indicate that higher shoe heel height leads to a decrease in the walking velocity and an increase in the activity and fatigue level of the lower leg muscles, particularly during long-distance walking.