• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.45-53
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• 2019

PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.

• Physical Therapy Korea
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• v.22 no.1
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• pp.37-48
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• 2015

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

• Journal of Digital Convergence
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• v.15 no.2
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• pp.411-419
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• 2017

This study was to investigate whether a trunk correction taping plus scapular setting exercises has an effect on trunk muscle activation and trunk balance and upper extremity function in patients with stroke. Twenty stroke patients were randomly divided into a trunk correction taping with scapular setting exercise group (n=10) and a scapular setting exercise group (n=10), and each group performed given interventions for 30 minutes for 4 weeks. In the experimental group, there were significant increases in muscle activation, K-TIS, and MFT (p<.05), and a significant improvement was detected in K-TIS and MFT compared to the control group (p<.05). This study suggests that a trunk correction taping with scapular setting exercises was more effective on trunk muscle activation, trunk balance, and upper extremity function in stroke patients compared to a scapular setting exercise. It could be clinically more significant if the change in the onset time of muscle activity is confirmed in the further researches.

• PNF and Movement
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• v.22 no.2
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• pp.201-211
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• 2024

Purpose: This study aimed to evaluate the effects of trunk stabilization exercises using a Reformer on trunk control, balance ability, and gait function in chronic stroke patients. Methods: The participants were 24 chronic stroke patients, randomly divided into two groups: trunk stabilization exercise using the Reformer group (TS-R, n = 12) and general trunk stabilization exercise group (GT-E, n = 12). Assessment methods included the Trunk Impairment Scale for trunk control, the AMTI force platform for static balance, the Timed Up and Go test for dynamic balance, and the Dynamic Gait Index for gait function. Assessments were conducted before and after the intervention. The intervention for the TS-R group consisted of bridging exercises using a Reformer, while the GT-E group performed bridging exercises on a mat. All interventions were performed for 17 minutes per session, five times a week, for a total of 20 sessions over four weeks. Statistical analysis was performed using repeated-measures ANOVA to analyze the interaction between groups and time. Results: The results of the repeated measures ANOVA indicated a significant interaction between the groups and time. The TS-R group showed statistically significant differences in all variables before and after the intervention. In contrast, the GT-E group did not show statistically significant differences in any variables before and after the intervention. Conclusion: The findings of this study suggest that trunk stabilization exercises using a reformer are effective in improving trunk control, balance ability, and gait function in chronic stroke patients.

• Journal of Korean Society of Transportation
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• v.26 no.5
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• pp.227-235
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• 2008

This study analyzed the efficiency of a trunk with branches and a trunk with feeders route system comparing the user cost and operator cost of those route systems. Basically, a trunk with branches is more efficient than a trunk with feeders in the passengers' perspective if the transit system of a trunk and feeders are the same. In the case that the trunk system is hierarchically higher than the feeder system, a trunk with feeders has the competitive edge over a trunk with branches if the saving of travel cost induced by using the trunk line is larger than the increasing waiting and transfer cost. This result is consistent with the previous research by Park et al.(2007c), which analyzed the efficiency of hierarchical structure in a grid transit network. If the travel demand of each origins and destinations is low, increasing headway according to the travel demand can increase passenger load or operating efficiency in a trunk with feeders route system. In this case, a trunk with feeders route system is more prevalent as the operating cost, route length, and number of destinations increases, while it is less prevalent as the transfer cost and passengers' time value of the waiting time increases. In cases that central business district, which is located in the middle of a trunk line, generates travel demand, a trunk with feeders is more efficient than a trunk with branches with the increasing travel demand from and to the CBD. Therefore it can be concluded that to have a dual operating system between CBD and suburban is more efficient than one type transit system. The efficiency of that system can be increased through an efficient transfer system that can reduce the transfer cost.

• Physical Therapy Korea
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• v.13 no.2
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• pp.61-69
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• 2006

The purpose of this study was to compare the electromyography (EMG) activities of the lumbar extensor muscles during motion of trunk flexion-extension and compare range of motion (ROM) with a 3-dimensional motion analysis system of the lumbar region between subjects with chronic low back pain (CLBP) and healthy subjects during the trunk flexion-extension, trunk rotation and trunk lateral flexion cycle. Thirty CLBP subjects and thirty healthy subjects were included. We measured the root mean square (RMS) value of the lumbar extensor muscles from resting, standing, lumbar flexion and return position. The RMS ratio was normalized from maximal EMG activity of the lumbar extensor muscles during trunk motion. The results of this study showed that the RMS ratio of the lumbar extensor was significantly higher in CLBP subjects than healthy subjects during all of trunk motion (p<.05). The ratio of the highest RMS value during flexion and extension was higher in CLBP subjects than in healthy subjects (p<.05). The ROM of the lumbar region was significantly lower in CLBP subjects than healthy subjects during trunk flexion-extension, trunk rotation and lateral flexion cycle. The relationship between the RMS ratio for full lumbar flexion and the ROM of lumbar flexion was not correlated significantly. CLBP subjects have both decreased ROM of the lumbar region and higher muscle activities of the lumbar extensor muscle than healthy subjects.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.430-437
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• 2021

Objective: The purpose of this study was to investigate the effect of 3-dimensional posture correction(3DPC) exercise program incorporating PNF respiratory muscle strengthening(RMS) exercise on spinal alignment and trunk expansion in patients with idiopathic scoliosis and the difference in intervention effect by type of idiopathic scoliosis. Design: Comparative study using paired t-test and analysis of variance measures. Methods: The subjects of this study were 5 men and 24 women diagnosed with idiopathic scoliosis with a Cobb angle greater than 10 degrees and less than 45 degrees. A 3DPC exercise program incorporating PNF RMS exercise was conducted twice a week for 1 hour per session for 6 weeks, and Cobb angle, Angle of trunk rotation, and trunk expansion were measured before and after the intervention. Results: After the intervention, Cobb angle and trunk rotation angle showed a statistically significant decrease, and trunk expansion showed a statistically significant increase. In the effect difference by type, there was a statistically significant difference in the angle of trunk rotation of the thoracic in 3C and Single Lumbar. Conclusions: In conclusion, it is thought that a 3DPC exercise program incorporating PNF RMS exercise can be effectively used in clinical practice to improve spinal alignment and trunk expansion in patients with idiopathic scoliosis.

• Physical Therapy Korea
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• v.17 no.1
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• pp.36-42
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• 2010

The aim of this study was to investigate effects of reaching distance on movement time and trunk kinematics in hemiplegic patients. Eight hemiplegic patients participated in this study. The independent variables were side (sound side vs. affected side) and target distance (70%, 90%, 110%, and 130% of upper limb). The dependent variables were movement time measured by pressure switch and trunk kinematics measured by motion analysis device. Two-way analysis of variance with repeated measures was used with Bonferroni post-hoc test. (1) There were significant main effects in side and reaching distance for movement time (p=.01, p=.02). Post-hoc test revealed that there was a significant difference between 110% and 130% of reaching distance (p=.01). (2) There was a significant main effect in side and reaching distance for trunk flexion (p=.01, p=.00). Post-hoc test revealed that there were significant differences in all pair-wise reaching distance comparison. (3) There was a significant side by target distance interaction for trunk rotation (p=.04). There was a significant main effect in target distance (p=.00). Post-hoc test revealed that there were significant differences between 70% and 110%, 70% and 130%, 90% and 110%, 90% and 130% of target distance. It was known that trunk flexion is used more than trunk rotation during reaching task in hemiplegic patients from the findings of this study. It is also recommended that reaching training is performed with limiting trunk movement within 90% of target distance whereas reaching training is performed incorporating with trunk movement beyond 90% of target distance in patients with hemiplegia.

• The Journal of Korean Physical Therapy
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• v.29 no.1
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• pp.33-38
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• 2017

Purpose: This study was conducted to investigate the effects of variations in arm swing during gait on movement of the trunk and pelvis. During the gait task, the angle of the trunk and pelvic rotation were analyzed according to arm swing conditions. Methods: Seventeen healthy males participated in this study. All subjects were analyzed for gait on a treadmill three times each under three different types of arm swing conditions - natural arm swing, restricted arm swing using a phone, restricted swing in both arms. 3-D motion analysis systems were used to collect and analyze the kinematic data of trunk and pelvic movements, and repeated one-way ANOVA was used to compare the trunk and pelvic kinematic data and symmetry index. The level of significance was ${\alpha}=0.05$. Results: The results showed kinematic differences in trunk and pelvic during gait based on the arm swing conditions. Specifically, there were significant differences in trunk rotation, left and right trunk rotation and symmetry index of trunk rotation during gait among the three arm swing conditions. ROM was used to calculate a symmetry index (SI) based on the average left and right trunk rotation in which a value closer to zero indicated better balance. The SI obtained for arm swing restricted with the phone was closer to -1 than the other conditions. Conclusion: Restricted arm swing due to use of a phone had the possibility to induce instability of postural control while walking, which could be seen to suggest a risk of falling during gait.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.25-33
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• 2017

PURPOSE: The initiation of the trunk muscles in stroke patients is delayed because the muscles involved in reach arm are activated earlier than the trunk muscles. The objective of this study was to examine the effects of mobility, balance, and trunk control ability through selective trunk exercise (STE) in patients with chronic stroke. METHODS: A randomized pre-test and post-test control group design was initially used, with subjects randomly assigned to the STE group (n=15) and a control group (n=14). All groups underwent physical therapy based on the neuro-developmental therapy (NDT) for 30 minutes a day, five times per week for four weeks. Additionally, the STE group did the trunk exercise for 30 minutes a day, three times per week for four weeks. The timed up and go test (TUG), Berg balance scale (BBS), and trunk impairment scale (TIS) were used for assessment. RESULTS: The scores of the TUG, BBS, dynamic sitting balance subscale, and coordination subscale of TIS improved significantly in both groups but the improvement was more pronounced in the STE group (p<.05). This study showed a large effect on the scores of the TIS coordination subscale (d=.93) (p<.05), TIS dynamic balance subscale (d=.81) (p<.05), TUG (d=.75) (p<.05), and BBS (d=.73) (p<.05). CONCLUSION: The combined STE and NDT program showed improvements in measures of mobility, balance, and trunk control in chronic stroke patients. These results suggest that STE should be considered to be included in the treatment program for patients with chronic stroke.