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Comparison of the Effects of PNF Neck Flexion and Curl-up Exercises on Abdominal Muscle Activity, Trunk Control, and Balance in Chronic Stroke Patients (PNF 목 굽힘 운동과 Curl-up 운동이 만성 뇌졸중 환자의 배근육의 활성도와 몸통 조절 및 균형에 미치는 효과 비교)

  • Kim, Gyeong-Don;Kim, Hyeon-Su
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.171-181
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    • 2020
  • Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

Effects of Pilates Exercises on Isokinetic Trunk Strength and Balance in Female Middle School Students with Lumbago (필라테스 운동이 여중생의 요통과 체간 등속성 근력 및 평형성에 미치는 영향)

  • Jung, In;Choi, Seung-Jun
    • PNF and Movement
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    • v.19 no.2
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    • pp.183-193
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    • 2021
  • Purpose: The purpose of this research was to investigate the effects of performing Pilates exercises for eight weeks on the isokinetic trunk strength and balance of female middle school students with lumbago. Methods: Twenty-four female students who met the test requirements were recruited and randomly divided into a control group (CG, n = 16) and a Pilates exercise group (Pilates group; PG, n = 8). The PG performed a Pilates program, which consisted of lumbar muscle strengthening exercises, for 60 minutes three times a week for eight weeks. Data analysis was conducted by two-way repeated ANOVA, and a Bonferroni test was carried out when significant differences appeared. The alpha level was set at 0.05. Results: Following the experimental treatment, the PG showed an increased trunk flexion peak torque of 17% and 13% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased about 31% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Following the experimental treatment, the PG showed an increased trunk extensor peak torque of approximately 29% and 21% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased approximately 27% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Both the CG and the PG showed a 20% and 50% decrease in pain index after the experimental treatment, respectively. After the experimental treatment, the PG had about 50% lower pain than the CG. The average error rate of static balance in the PG reduced by 19% from 3.28±0.45 to 2.65±0.36, confirming a significant improvement. Conclusion: Regular Pilates exercise for eight weeks improved the isokinetic trunk muscle strength of female middle school students with lumbago and relieved their pain. Pilates was also shown to be effective in improving balance.

The effect of balance training using visual information on the trunk control, balance and gait ability in patients with subacute stroke: Randomized controlled trial

  • Choi, Sung-Hoon;Lee, Ji-Young;Lee, Byoung-Hee
    • Journal of Korean Physical Therapy Science
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    • v.29 no.2
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    • pp.1-13
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    • 2022
  • Background: This research was conducted to understand balance training in trunk control, balance, and walking in stroke patients. Design: Randomized controlled trial. Methods: The subjects included 40 stroke patients, of whom 20 undertook balance training using visual information and the other 20 undertook balance training using balance boards. Using visual feedback, the balance training group used a training program within the static balanced evaluation tool, while the balance training group trained using a balance board. All subjects underwent 20 mins of neurodevelopmental treatment, and both target groups underwent 10 mins each of balance training by using either visual feedback or a balance board. The treatment period lasted a total of 4 weeks, twice a day. Trunk control before and after training was evaluated with the Trunk Impairment Scale. Balance capability was assessed by the Berg Balance Scale, Functional Reach Test, Timed Up and Go test, and Static balance measurement tool. Walking capacity was measured using gait measuring equipment, and cadence and velocity were measured. Results: Both groups showed a significant improvement in their interstitial control, balance, and gait ability after the experiments compared to before the experiments (p<0.05). The difference between the two groups was not significant. The visual feedback balance training group showed a more substantial improvement than the balance board training group. Conclusion: In this study, we found that the balance training combined with visual feedback contributes to improving trunk control, balance, and gait in patients with hemiplegia due to stroke. In addition to this, I believe that balanced training combined with visual feedback can be used as a training method when considering patients who lack interstitial control, balance, and gait ability.

Effect of Core Stabilization Intervention Program on Erector Spinae Contractile Properties and Isokinetic Muscle Function in Adults with Sedentary Lifestyle Patterns (코어안정화 운동이 좌식생활 패턴 성인의 척추기립근 수축 속성 및 체간 등속성 근기능에 미치는 영향)

  • Lee, Hyungwoo;An, Seungho;Jeon, Kyoungkyu
    • Korean Journal of Applied Biomechanics
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    • v.32 no.3
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    • pp.103-110
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    • 2022
  • Objective: The aim of this study was to investigate effect of core stabilization exercises on the erector spinae contractile properties and trunk isokinetic muscle function of middle age with low physical activity and sedentary lifestyle. Method: Twenty (female: n=10, male: n=10) middle-age subjects (age: 37.25 ± 6.08 years, height: 168.01 ± 6.84 cm, weight: 71.37 ± 11.75 kg) participated in this study. Tensiomyography was measured on the erector spinae, and the isokinetic trunk muscle function test was measured at an angular velocity of 60 °/s and 90 °/s. All subjects performed the core stabilization exercises for 60 min per day, 3 times a week, for 7 weeks. A paired t-test was performed with a significance level of 0.05. Results: Tensiomyography of the erector spinae revealed a significant post-exercise increase in the maximum radial displacement (p < .05) and velocity of contraction (p < .05), however, there wasn't a significant post-exercise change in the contraction time. Additionally, the isokinetic muscle function test of the trunk revealed a significant post-exercise increase in trunk extensor relative strength (p < .05) and strength ratio (p < .05). Conclusion: Our results indicated that core stabilization exercises reduced erector spinae muscle stiffness, increased the velocity of erector spinae contraction. Additionally, data showed the improvement in the trunk extensor strength help induce a more balanced development in trunk muscle.

The Reliability and Validity of the Digital Goniometer and Smart Phone to Determine Trunk Active Range of Motion in Stroke Patients

  • Park, Hee-yong;Hwang, Ui-jae;Kwon, Oh-yun
    • Physical Therapy Korea
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    • v.29 no.3
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    • pp.225-234
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    • 2022
  • Background: Trunk movements are an important factor in activities of daily living; however, these movements can be impaired by stroke. It is difficult to quantify and measure the active range of motion (AROM) of the trunk in patients with stroke. Objects: To determine the reliability and validity of measurements using a digital goniometer (DG) and smart phone (SP) applications for trunk rotation and lateral flexion in stroke patients. Methods: This is an observational study, in which twenty participants were clinically diagnosed with stroke. Trunk rotation and lateral flexion AROM were assessed using the DG and SP applications (Compass and Clinometer). Intrarater reliability was determined using intraclass correlation coefficients (ICCs) with 95% confidence intervals. Pearson correlation coefficient was used to determine the validity of the DG and SP in AROM measurement. The level of agreement between the two instruments was shown by Bland-Altman plot and 95% limit of agreement (LoA) was calculated. Results: The intrarater reliability (rotation with DG: 0.96-0.98, SP: 0.98; lateral flexion with DG: 0.97-0.98, SP: 0.96) was excellent. A strong and significant correlation was found between DG and SP (rotation hemiplegic side: r = 0.95; non-hemiplegic side: r = 0.90; lateral flexion hemiplegic side: r = 0.88; non-hemiplegic side: r = 0.78). The level of agreement between the two instruments was rotation (hemiplegic side: 23.02° [LoA 17.41°, -5.61°]; non-hemiplegic side: 31.68° [LoA 23.87°, -7.81°]) and lateral flexion (hemiplegic side: 20.94° [LoA 17.48°, -3.46°]; non-hemiplegic side: 27.12° [LoA 18.44°, -8.68°]). Conclusion: Both DG and SP applications can be used as reliable methods for measuring trunk rotation and lateral flexion in patients with stroke. Although, considering the level of clinical agreement, DG and SP could not be used interchangeably for measurements.

Effects of Half Squats with Kinesio Taping on Trunk and Lower Extremity Muscle Activity and Balance Ability in University Students (키네시오 테이핑을 병행한 하프 스쿼트 훈련이 일반인의 몸통과 다리 근활성도 및 균형능력에 미치는 영향)

  • Kim, Kyung-Hun
    • PNF and Movement
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    • v.20 no.2
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    • pp.253-262
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    • 2022
  • Purpose: The aim of this study was to identify the effects of performing the half squat exercise with Kinesio taping (HSEKT) on trunk and lower extremity muscle activity and balance ability in general university students. Methods: The 32 participants were randomly assigned to either the HSEKT group (half squats with Kinesio taping) or the control group (half squats with sham Kinesio taping). Both groups performed half squats with either Kinesio taping (HSEKT group) or sham Kinesio taping (control group) for 30 min/day, 3 times/week for 6 weeks. The Noraxon mini direct transmission system (DTS) electromyography (EMG) system was used to evaluate trunk and lower extremity muscle activity. BioRescue equipment was used to measure the movement area of the center of pressure with eyes open and eyes closed. The muscle activity of the trunk and lower extremities and the balance ability of all participants were measured before and after the intervention. An independent t-test was used to statistically analyze the pre- and post-intervention EMG and balance ability results. Results: The trunk and lower extremity muscle activity was found to have significantly improved in the HSEKT group and the control group after the intervention (p < 0.05). Also, the balance ability of the HSEKT group differed significantly after 6 weeks of training compared to that of the control group (p < 0.05). Conclusion: The findings of this study show that performing half squats with Kinesio taping had a positive effect on trunk and lower extremity muscle activity and balance ability in general university students.

Clinical Applications of the Intercostal Artery Perforator Flap for Trunk Reconstruction

  • Young Jun Kim;Woo Young Choi;Ji Seon Cheon;Min Hyub Choi
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.233-239
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    • 2023
  • Background Trunk defects can occur because of surgical site infections after spinal surgery, resection of malignant tumors, or trauma. Herein, we present our experience of using intercostal artery perforator (ICAP) flaps to reconstruct trunk defects without noteworthy complications. Fourteen patients underwent reconstruction with ICAP flaps between March 2015 and March 2019. Methods Patients' data, including age, sex, the cause of the defect, defect size, perforator location, flap size, complications, and follow-up period, were retrospectively reviewed. The mean age of the patients was 56.5 years (range, 19-80 years). All operations were performed after the results of bacterial culture from the wound showed no microbial growth. We found reliable perforators around the defect using Doppler ultrasonography. The perforator flaps were elevated with a pulsatile perforator and rotated in a propeller fashion to the defects. We performed five dorsal and two lateral ICAP flaps. The mean flap dimensions were 12 × 5.5 cm2 (range, 6 × 5 to 18 × 8 cm2). Results Primary closure of the donor site was performed. Marginal congestion was observed as a complication in one case, but it healed with no need for revision. The mean follow-up period was 8 months. All patients were satisfied with the surgical outcomes. Conclusion ICAP flaps can be easily mobilized, thereby reducing donor site morbidity without sacrificing the underlying muscles for trunk reconstruction. Therefore, these flaps are useful options for the reconstruction of trunk defects.

Reliability and Validity of Angle of Trunk Rotation Measurement Using Smartphone and 3D Printing Technology in Scoliosis

  • Geum-Dong Shin;Seong-gil Kim;Kyoung Kim
    • The Journal of Korean Physical Therapy
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    • v.34 no.6
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    • pp.283-291
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    • 2022
  • Purpose: The purpose of this study was to compare and analyze the method of measuring the angle of the trunk rotation using a smartphone with 3D smartphone holder compared to a scoliometer, which is a measuring tool used as a method for diagnosing scoliosis in scoliosis patients. Methods: Angle of trunk rotation was measured in 21 subjects diagnosed with scoliosis. scoliometer measurement method, a smartphone measurement method with a 3D smartphone holder, a smartphone blind measurement method with a 3D smartphone holder, a smartphone measurement method without a smartphone holder, a smartphone blind measurement method without a smartphone holder, and a total of five measurement methods were repeated three times for comparison and analysis. Results: The smartphone measurement method with a 3D smartphone holder has excellent intra-rater reliability of angle of trunk rotation (Rater A; ICC3, 2≥0.993, Rater B; ICC3, 2≥0.992). The smartphone blind measurement method with a 3D smartphone holder has excellent inter-rater reliability of angle of trunk rotation (ICC2, 2≥0.968). The scoliometer measurement method had the highest validity (r=0.976) with the smartphone measurement method with a 3D smartphone holder, and the blind measurement method without a smartphone holder had the lowest validity (r=0.886). Conclusion: These findings, the angle of trunk rotation measured by the smartphone measurement method with a 3D smartphone holder in scoliosis patients showed high reliability and validity compared to the scoliometer measurement method.

The Effects of Trunk Movement and Ground Reaction Force during Sit to Stand Using Visual Feedback (시각 되먹임을 이용한 앉은 자세에서 일어서기 시 몸통의 동작과 지면 반발력에 미치는 영향)

  • Yeong-Geon Koh;Tae-Young Oh;Jae-Ho Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.207-219
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    • 2023
  • Purpose : This study was conducted to investigate the changes in trunk movement and ground reaction during sit to stand motion using visual feedback. Methods : Fifteen adults (average age: 23.53±1.77 years) participated in this study. An infrared reflective marker was attached to the body each participant for motion analysis, and the participants performed sit to stand motion while wearing a hat attached with a laser pointer, which provided visual feedback. First, the sit to stand action was repeated thrice without obtaining any visual feedback, followed by a three minute break. Next, the laser pointers attached to hats were irradiated on a whiteboard, located at a distance of 5 m in front of the chairs, on which the participants sat; a baseline was set, and the participants performed stand up movements three times under this condition. A visual feedback was provided to the participants to prevent the laser pointers from crossing the set baseline. During each stand-up movement, the position of the reflective marker attached to the subject's body was recorded in real time using an infrared camera for motion analysis. The trunk movement and ground reaction force were extracted through recorded data and analyzed according to the presence or absence of visual feedback. Results : The results indicated that in the presence of a visual feedback during the sit-to-stand movements, the range of motion of the trunk and hip joints decreased, whereas that of the knee and ankle joints increased in the sagittal plane. The rotation angle of the trunk in the horizontal plane decreased. The left and right movement speed of the center of pressure increased, the pressing force decreased, and the forward and backward movement speed of the trunk decreased. Conclusion : The results suggest that the efficiency and stability of the stand up movement of a body increase when a visual feedback is provided.

A study on the determination of location of the detention pond in trunk sewer for reducing runoff amounts (우수유출저감을 위한 간선저류지 위치선정에 관한 연구)

  • Lee, Sung Ho;Yoon, Sei Eui;Lee, Jae Joon
    • Journal of Korea Water Resources Association
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    • v.50 no.4
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    • pp.223-232
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    • 2017
  • The ability to defend against floods in urban areas was weakened, because the increase in the impervious rate of urban areas due to urbanization and industrialization and the increase in the localized torrential rainfall due to abnormal climate. In order to reduce flood damage in urban areas, various runoff reduction facilities such as detention ponds and infiltration facilities were installed. However, in the case of domestic metropolitan cities, it is difficult to secure land for the installation of storm water reduction facilities and secure the budget for improving the aged pipelines. Therefore, it is necessary to design a storage system (called the detention pond in trunk sewer) that linked the existing drainage system to improve the flood control capacity of the urban area and reduce the budget. In this study, to analyze the effect of reducing runoff amounts according to the volume of the detention pond in trunk sewer, three kinds of virtual watershed (longitudinal, middle, concentration shape) were assumed and the detention pond in trunk sewer was installed at an arbitrary location in the watershed. The volume of the detention pond in trunk sewer was set to 6 cases ($1,000m^3$, $3,000m^3$, $5,000m^3$, $10,000m^3$, $20,000m^3$, $30,000m^3$), and the installation location of the detention pond in trunk sewer was varied to 20%, 40%, 60%, and 80% of the detention pond upstream area to the total watershed area (DUAR). Also, using the results of this study, a graph of the relationship and relational equation between the volume of the detention pond in trunk sewer and the installation location is presented.