• PNF and Movement
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• v.17 no.1
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• pp.1-9
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• 2019

Purpose: This study investigates the effects of task-oriented training for a left trunk flexion pattern using real-time ultrasound imaging in a stroke patient with unilateral neglect symptoms. Methods: This study used the ABA experimental design, which is a single-subject research method among individual case research methods. For the ABA experimental design, changes in the degree of unilateral neglect, balance ability, and the thickness of the lateral abdominal muscle were visually analyzed during the baseline process, in the intervention period, and after the intervention. The experiments were performed 24 times in total for 8 times in each of the 3 periods. The unilateral neglect was measured using the Albert test, balance ability was measured using the Berg balance test, and the thickness of the lateral abdominal muscle was measured using ultrasound imaging. The subject was a 50-year-old male patient with unilateral neglect caused by right cerebral hemorrhage. He performed task-oriented training for a voluntary left trunk flexion pattern using real-time ultrasound imaging during the intervention period. Results: The result of comparing the data collected during the intervention period with the data point average of the baseline process showed that balance ability improved and the tendency line was above the baseline. The tendency line of unilateral neglect was below the baseline and showed a decreasing tendency. The thickness of the lateral abdominal muscle showed an increasing trend and the tendency line was above the baseline. Conclusion: The results of this study suggest that the task-oriented training for left trunk flexion pattern using real-time ultrasound imaging has a beneficial effect on balance ability, the degree of unilateral neglect, and the strength of the lateral abdominal muscle in unilateral neglect patients.

• Physical Therapy Korea
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• v.24 no.4
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• pp.1-10
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• 2017

Background: Flexion-relaxation phenomenon (FRP) was a term which refers to a sudden onset of myoelectric silence in the erector spinae muscles of the back during standing full forward flexion. Hamstring muscle length may be related to specific pelvic and trunk movements. Many studies have been done on the FRP of the erector spinae muscles. However, no studies have yet investigated the influence of hamstring muscle flexibility on the FRP of the hamstring muscle and lumbopelvic kinematics during forward bending. Objects: The purpose of this study was to examine the flexion-relaxation ratio (FRR) of the hamstring muscles and lumbopelvic kinematics and compare them during forward bending in subjects with different hamstring muscle flexibility. Methods: The subjects of two different groups were recruited using the active knee extension test. Group 1-consisted of 13 subjects who had a popliteal angle under $30^{\circ}$; Group 2-consisted of 13 subjects who had a popliteal angel above $50^{\circ}$. The kinematic parameters during the trunk bending task were recorded using a motion analysis system and the FRRs of the hamstring muscles were calculated. Differences between the groups were identified with an independent t-test. Results: The subjects with greater hamstring length had significantly less lumbar spine flexion movement and more pelvic flexion movement. The subjects with greater pelvic flexion movement had a higher rate of flexion relaxation during full trunk bending (p<.05). Conclusion: The results of this study suggest that differences in hamstring muscle flexibility might cause changes in people's hamstring muscle activity and lumbopelvic kinematics.

• Physical Therapy Korea
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• v.26 no.3
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• pp.32-41
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• 2019

Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending. Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings. Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending. Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.63-74
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• 2008

Purpose : The purpose of this study was to compare trunk repositioning errors between subjects with and without low back pain in sitting and standing. Methods : Total 81 participants were recruited who consisted of 41 subjects with low back pain and 40 normal subjects. The subjects were instructed to replicate the predetermined target positions of the trunk toward upright and $30^{\circ}$ flexion in sitting and standing. During each of movement, digital inclinometer was used to measure the angular movement of $T_{12}$ spinal process. Repositioning error was calculated as the absolute difference between the predetermined target positions and replicated target positions. Results : In subjects with low back pain, upright repositioning error was $1.26^{\circ}{\pm}0.14^{\circ}$ in sitting and $1.55^{\circ}{\pm}0.24^{\circ}$ in standing, and $30^{\circ}$ flexion repositioning error was $3.23^{\circ}{\pm}0.33^{\circ}$ in sitting and $5.50^{\circ}{\pm}0.50^{\circ}$ in standing. In subjects without low back pain, upright repositioning error was $1.38^{\circ}{\pm}0.15^{\circ}$ in sitting and $1.67^{\circ}{\pm}0.18^{\circ}$ in standing, and flexion repositioning error was $2.61^{\circ}{\pm}0.28^{\circ}$ in sitting and $3.70^{\circ}{\pm}0.52^{\circ}$ in standing. It was demonstrated that flexion repositioning error increased significantly in standing position. In subjects with low back pain, $30^{\circ}$ flexion repositioning error was significantly higher in standing than in sitting. Conclusion : The repositioning error of subjects with low back pain increased during flexion and it implies that some aspects of proprioception are decreased in subjects with low back pain. Therefore, it will be emphasis that a clinical trial to increase the trunk flexion stability of subjects with low back pain in standing.

• Journal of Korean Physical Therapy Science
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• v.19 no.1
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• pp.1-7
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• 2012

Purpose : This study aims to examine effects of trunk strengthening exercise in three rigid cerebral palsy adolescents aged between 11 and 13 on their spinal segments and gait. Methods : 2A trunk strengthening program for proprioceptive neuromuscular facilitation was made focusing on improvement in their school life and mental and social activities during their school years, and then trunk strengthening exercise was applied to the three subjects for 30 minutes five times per week for four weeks. With the subjects in a static state, each group's gait analysis was made and maximum anterior flexion, maximum extension, maximum left and right lateral flexion, and cross rotation of the trunk were measured using Sonosens (Germany) prior to and after the intervention. Results : Assessment of spinal segment mobility with the subjects in a static state showed that the trunk muscle strengthening exercise increased their maximum joint movement angles from the right side to the center and rotational abilities of the cervical and lumbar spines. Gait analysis indicated increased movements in the thoracic and lumbar spines and relatively decreased anterior-posterior movement of the cervical spine. Conclusion : Trunk strengthening program is effective in enhancing spinal segment mobility and balance ability of cerebral palsy adolescents and considered able to be used together with diverse treatment interventions.

• Physical Therapy Korea
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• v.16 no.2
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• pp.1-8
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• 2009

Anticipatory postural adjustments is an example of the ability of the central nervous system to predict the consequence of the mechanical effect of movement on posture and helps minimize a forth coming disturbance. The aim of this study was to evaluate the sequence of activation of the trunk muscles during the performance of hip and shoulder movement and to determine the relationship between anticipatory activity and subjects' motor and functional status in subjects with hemiplegia post stroke. Twenty-four poststroke hemiparetic patients enrolled in this study. Electromyographic activity of the lumbar erector spinae, latissimus dorsi, and of the obliquus internus muscles was recorded bilaterally during flexion of both arm and from the rectus abdominis, obliquus externus, and obliquus internus muscles during flexion of both hip. Onset latencies of trunk muscles were partially delayed in the subjects with hemiplegia post stroke (p<.05). With upper limb flexion, the onset of erector spinae muscle and latissimus dorsi muscle activity preceded the onset of deltoid on both side respectively (p<.05). A similar sequence of activation occurred with lower limb flexion. Also the onset of external oblique muscle and rectus abdominis muscle activity preceded the onset of rectus femoris muscle on both side (p<.05). Major impairments in the activity of trunk muscles in hemiparetic subjects were manifested in delayed onset between activation of pertinent muscular pairs. These problems were associated with motor and functional deficits and warrant specific consideration during physical rehabilitation of post stroke hemiparetic patients.

• Korean Journal of Applied Biomechanics
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• v.16 no.1
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• pp.159-166
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• 2006

The purpose of this study were analysed fatigue character of lumbar extension Muscle during repeated trunk flexion-extension motion we used EMG multi-telemeter (WEB 5000, Nihon Koden, Japan), Medex lumbar extension machine(Ocala, USA). We evaluated 20 persons on chronic low back pain group and 20 persons on control group. We analysed the quantitative variables IMF, MF, decreased ratios of MF to investigate fatigue. As a result, the following conclusion was drawn : 1. Each lumbar IMF of CLBP was L5> L3> L1 in the order of their size. CON group was similar quantitative and same order. But the relationship of two groups were not significantly. 2 The IMF within lumbar position(L1-L3, L1-L5, L3-L5) of two groups was significantly all positions(p<.05). 3. The MF shifting at lumbar position of two groups during repeated trunk flexion-extension motion was decrease shifting pattern with increase repeating motion, especially CLBP group was suddenly dropping than CON at all lumbar positions(L1, L3, L5) on early stage motion(34 set). 4. The lumbar fatigue of CLBP was higher than CON during repeated trunk flexion-extention motion, so CLBP supposed more tired than CON. And it was significantly within two groups at lumbar positions(L1, L3 : p<.05, L5 : P<.01).

• Physical Therapy Korea
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• v.19 no.3
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• pp.11-19
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• 2012

This study aimed to investigate whether isometric lower limb exercise can activate contralateral trunk muscles and whether the magnitude of muscle activation is related to lower limb movement in sitting. This study included 25 healthy young subjects (20 males and 5 females). The magnitude of trunk muscle activation was measured using surface electromyography (EMG) during hip flexion, extension, adduction, and abduction, and a significant difference was observed in the activation levels of trunk muscles among the tests (p<.01). The EMG activity of the multifidus (MF) and erector spinae (ES) muscles on the contralateral side were significantly greater during hip extension. However, the activation levels of the contralateral internal oblique (IO) and rectus abdominis (RA) muscles were greatest during hip flexion. The MF : ES EMG ratio was significantly greater during hip isometric during hip isometric flexion and abduction compared to hip extension and adduction. There was no significantly difference in the IO : RA ratio during the isometric contractions toward different directions. These findings indicate that isometric lower limb exercise can elicit trunk muscle contraction on the contralateral side and may therefore be helped for developing contralateral trunk muscle strength in individuals undergoing rehabilitation.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.156-160
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• 2021

Objective: Low back pain easily becomes chronic and has a high recurrence rate. Therefore, it is most important to prevent chronicity and reduce the risk of recurrence in the early stages of back pain or at the stage with mild pain. Therefore, this study was conducted to compare hip joint muscle strength, trunk muscle endurance, and pelvic alignment between subjects with mild low back pain and subjects without back pain. Design: Crossed-sectional study Methods: The study was conducted by recruiting 30 students in their twenties who are enrolled in K University in Gyeongsangnam-do, and classifying them into 15 patients with mild back pain and 15 patients with normal. The subjects who participated in the experiment were measured for hip flexor and extensor muscle strength, trunk flexion and extension muscle endurance, and pelvic alignment. To measure hip joint muscle strength, biodex was used, and muscle endurance of the trunk was recorded at the end range of the trunk flexion and extension. And pelvic alignment was measured using Formetric 4D. Results: There were no significant differences in hip joint muscle strength, pelvic alignment, and trunk extension muscle endurance. The retention time was found to be significantly shorter in the mild low back pain group than in the normal group for trunk flexion muscle endurance. Conclusions: In the early stages of back pain or in the mild pain stage, training to increase muscle endurance of the flexor muscles may be helpful.

• Journal of the Ergonomics Society of Korea
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• v.22 no.4
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• pp.47-57
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• 2003

This study investigated the recruitment patterns of ten trunk muscles in isometric exertion tasks, focused on the functional roles (agonist or antagonist). Twelve male students performed maximum voluntary isometric exertion tasks towards six directions: flexion/extension, left/right lateral bending, and clockwise/counter-clockwise twisting. EMG signals from ten trunk muscles and exertion forces were collected. Normalized EMG (NEMG) values were calculated at 10, 20, 30, 40, 50, 60, 70, 80, and 90 %MVC. The subjects showed a limited capacity in producing twisting moments, approximately 50% of the extension moment, and 70% of lateral bending moments. EMG activity was dependent on the direction and magnitude of the exertion, and also on the functional role. The mean NEMG of agonist was 0.260 and 0.067 for antagonist. Agonists showed the highest mean NEMG in flexion (0.367), while antagonists showed the highest mean NEMG in twisting clockwise/counter-clockwise (0.090/0.106).