• 대한통합의학회지
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• 제6권4호
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• pp.15-27
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• 2018

Purpose : This study aims to present a rehabilitation exercise and physical education program (REPEP) for local community stroke patients by examining an exercise program provided from traditional physical therapeutic perspectives. Methods : The subjects were 40 stroke patients residing in a local community and managed by a public health center (the group-exercise group: 20, the individual-exercise group: 20). In the case of the group-exercise group (GEG), the subjects were divided into small groups composed of five members each to participate in the program. The individual-exercise group (IEG) took part in the program individually. The subjects received a REPEP that included a warm-up exercise, an elastic band exercise, a leg exercise, a balance and gait exercise, an arm and trunk exercise, and a cool-down exercise twice per week for 20 weeks. They had their gait function, balance index, and muscle strength in the bilateral knee joints tested before and after the experiment. Results : Compared to before the experiment, both groups' gait function, balance index, and muscle strength in the knee joints increased after the experiment. After the experiment, the GEG experienced more improvement in their gait function, balance index, and muscle strength in the bilateral knee joints, excluding their gait velocity and $300^{\circ}/sec$ flexion and extension, than the IEG (p<.05). Conclusion : An exercise program provided from the traditional physical therapeutic perspectives may be applied to stroke patients as their REPEP. In addition, a REPEP was more effective in improving their gait function, balance index, and muscle strength in the knee joints when the subjects formed a group and took part in the program than when they partook in it individually.

• 대한물리의학회지
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• 제14권2호
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• pp.125-135
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• 2019

PURPOSE: This study examined the effects of low frequency neuromuscular electrical stimulation (NMES) training on abdominal obesity in middle-aged women through electromyography and ultrasound. METHODS: Twenty-two middle aged women with abdominal obesity participated in the study. A low-frequency NMES device was used on the abdomen and waist of each subject for 20 minutes each (a total of 40 minutes) three times a week for eight weeks. The waist-hip ratio (WHR), weight and BMI (Body Mass Index) were measured. Electromyography (EMG) and ultrasound measurements were performed three times in total (pre-intervention, four weeks into the intervention, and eight weeks post-intervention) to examine the effects of low-frequency NMES on the abdominal muscle activity, muscle thickness, and subcutaneous fat. RESULTS: The results indicated a difference in the WHR and waist circumference before and after intervention (p<.05). The external oblique muscle (EO) showed a significant increase in muscle activity during all measurements taken post-intervention (p<.05). The abdominal subcutaneous fat thickness also showed a significant decrease between each measurement (p<.05). The test results showed that the abdominal subcutaneous fat thickness values taken eight weeks post-intervention were significantly lower than those taken pre-intervention and four weeks into the intervention (p<.05). CONCLUSION: These findings show that low-frequency NMES device training can be applied to middle-aged women with abdominal obesity to improve their body shape and exercise performance.

• 한국전문물리치료학회지
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• 제28권3호
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• pp.186-193
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• 2021

Background: While the formal test has been used to provide a quantitative measurement of core stability, studies have reported inconsistent results regarding its test-retest and intraobserver reliabilities. Furthermore, the validity of the formal test has never been established. Objects: This study aimed to establish the concurrent validity and test-retest reliability of the formal test. Methods: Twenty-two young adults with and without core instability (23.1 ± 2.0 years) were recruited. Concurrent validity was determined by comparing the muscle thickness changes of the external oblique, internal oblique, and transverse abdominal muscle to changes in core stability pressure during the formal test using ultrasound (US) imaging and pressure biofeedback, respectively. For the test-retest reliability, muscle thickness and pressure changes were repeatedly measured approximately 24 hours apart. Electromyography (EMG) was used to monitor trunk muscle activity during the formal test. Results: The Pearson's correlation analysis showed an excellent correlation between transverse abdominal thickness and pressure biofeedback unit (PBU) pressure as well as internal oblique thickness and PBU pressure, ranging from r = 0.856-0.980, p < 0.05. The test-retest reliability was good, intraclass correlation coefficient (ICC1,2) = 0.876 for the core stability pressure measure and ICC1,2 = 0.939 to 0.989 for the abdominal muscle thickness measure. Conclusion: Our results provide clinical evidence that the formal test is valid and reliable, when concurrently incorporated into EMG and US measurements.

• The Journal of Korean Physical Therapy
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• 제28권5호
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• pp.297-302
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• 2016

Purpose: This study was conducted to evaluate the effects of bridge exercise on the structural characteristics of trunk muscles in patients with lumbar pain by applying the exercise on either a stable or an unstable surface. Methods: Thirty subjects participated in the experiment and were randomly divided into an unstable bridge exercise group (UBEG) and a stable bridge exercise group (SBEG). The exercise program for each group was conducted three times a week over a six-week period. The structural characteristics of trunk muscles were measured by obtaining images using an ultrasound imaging device. Results: The thicknesses of the external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) and the fiber angle of the erector spinae (ES) in the UBEG and the SBEG showed statistically significant increases in all items measured after the experiment. A comparison of groups conducted after the experiment to determine the effects of the exercise on each group showed no significant differences between groups for any of the measured items. Conclusion: A comprehensive review of the study results showed statistically significant increases in the thicknesses of the EO, IO, and TrA and the fiber angle of ES in both the UBEG and the SBEG. While the comparison of the groups with respect to the effects of the exercise revealed no significant differences, there were relatively larger effects in the UBEG than in the SBEG.

• 대한정형도수물리치료학회지
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• 제23권1호
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• pp.1-6
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• 2017

Purpose: The purpose of this study was to explore the influence of a sling suspension exercise with abdominal drawing-in maneuver (ADIM) on the thickness of abdominal muscles. Method: Twenty healthy young women volunteered for this study, and they were randomly assigned to either the control group or experimental group. Subjects of both groups performed the ADIM in standard method. And subjects of the experimental group underwent a structured sling exercises additionally, which consists of bridging exercise on supine, elbow support and trunk control exercise on prone, and trunk flexion exercises. The exercises were performed thirty minutes per day, 3 times a week for a 4-week period. Thickness of abdominal muscles (transverse abdominis; TrA, internal obliques; IO and external obliques; EO) was measured by using real-time ultrasonography. Results: After the intervention, subjects of the experimental group appeared to be significantly increased for the thickness of the TrA (p<.05). However, significant difference weren't found for the IO and EO (p>.05). Conclusion: These findings suggest that sling suspension exercise with the ADIM may be favorably used to augment trunk stabilizing effort by increasing TrA thickness. Further studies need in this field.

• 한국전문물리치료학회지
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• 제10권1호
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• pp.63-76
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• 2003

This research was performed to compare spinal segment motion angle between low back pain (LBP) group and painless group during trunk flexion-extension and to investigate the effect of transversus abdominis strengthening exercise on spinal segment motion angle in LBP group. Nine subjects with LBP and ten subjects without LBP participated. Transversus abdominis strengthening exercise was performed in LBP group for three weeks, and spinal segment motion angles were compared before and after the exercise performance. Spinal segment motion angles were measured both in sitting and standing position. Results were as followed: 1) Subjects' average age was 24.79 years, height was 167.84 cm, and weight was 59.95 kg. 2) Spinal segment motion angle of T10/l1 was significantly higher in LBP group compared with painless group (p<.05) in sitting position during trunk flexion-extension. 3) In sitting position, whereas entire lumbar segment motion angles were lower in LBP group compared with painless group (p<.05), angle of L4/5 was higher in LBP group compared with painless group (p<.05). 4) There was no significant difference in thoracic segment motion angle in standing position. 5) After three weeks of transversus abdominis strengthening exercise, thoracic segment motion angle increased both in sitting and standing position (p<.05). 6) In painless group, there was no significant difference in entire spinal segment motion angles in sitting and standing position (p>.05). When spinal segment motion angles were compared between sitting and standing position, there were slight differences. In sitting position, there was no difference in spinal segment motion angle between LBP group and painless group while hip joint motion angle and sacral inclination angle of LBP group was lower than those of painless group (p<.05). In standing position, lumbar segment motion angle was significantly lower in LBP group than that of painless group. Transversus abdominis strengthening exercise influenced thoracic segment motion angle more significantly than lumbar segment motion angle.

• 국제물리치료학회지
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• 제3권2호
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• pp.413-421
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• 2012

Few studies address the use of manual muscle stretching to improve spinal active range of motion(AROM). There is evidence that' Hold-Relax'(HR) is effective for increasing ROM in the extremities, which leads the researchers to anticipate similar benefits in the spine. The purpose of this study is to investigate the effects of HR(trunk flexors) and active thoracic flexion and extension on thoracic mobility, specifically flexion and extension in healthy individuals. A convenience sample of 30 physical therapy students(22-38 years) were randomly assigned to intervention sequence 'A-B' or 'B-A', with at least 7 days between interventions. Intervention' A' consisted of HR of the ventral trunk musculature while 'B' consisted of thoracic flexion-extension AROM. Thoracic flexion and extension AROM were measured before and after each intervention using the double inclinometer method. Paired t-tests were used to compare AROM pre and post-intervention for both groups, and to test for carry-over and learning effects. There was a statistically significant increase(mean=$3^{\circ}$ ; p=0.006) in thoracic extension following HR of the trunk flexors. There were no significant changes in thoracic flexion following HR, or in flexion or extension following the AROM intervention. No carryover or learning effects were identified. HR may be an effective tool for improving AROM in the thoracic spine in pain free individuals. Further investigation is warranted with symptomatic populations and to define the minimal clinical difference(MCD) for thoracic spine mobility.

• PNF and Movement
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• 제19권1호
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• pp.127-135
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• 2021

Purpose: The purpose of this study was to determine the effect of the side-bridge exercise on the thicknesses of the external and internal obliques, the transverse abdominis, and the erector spinae, which are some of the trunk muscles of healthy adult males and females. Methods: There were 30 subjects divided into two groups with 15 subjects in the modified side-bridge exercise group and 15 subjects in the bridge exercise group. The changes in each variable were analyzed before the exercise, after three weeks, and after six weeks of exercise using a two-way repeated analysis of variance. The significance level was set at 0.05. When there was any interaction between the time of measurement and each group, a paired t-test was conducted to find the difference within groups and an independent-sample t-test was conducted to find the difference between groups. The significance level for both tests was set at 0.01. Results: There was a significant difference in the external and internal obliques and the erector spinae according to changes over time and the interactions between the time and groups (p < 0.05). However, there was a significant difference in the transverse abdominis only according to the interaction between the length of times (p < 0.05). Conclusion: The study results indicated that the modified side-bridge exercise significantly increased the thickness of the external and internal obliques and the erector spinae. This suggests the usability of the exercise in lumbar stabilization exercises in future studies and clinical fields.

• 국제물리치료학회지
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• 제10권2호
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• pp.1750-1755
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• 2019

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal $CO_2$ ($EtCO_2$) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at ${\alpha}=.05$. Results: The patients with CLBP had significantly less $EtCO_2$ and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.

• 한국전문물리치료학회지
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• 제19권4호
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• pp.38-45
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• 2012

The aim of this study is to compare the effect of abdominal drawing-in maneuver (ADIM) on lower trapezius (LT), serratus anterior (SA), and erector spinae (ES) muscle activity during arm lifts in prone and standing positions. Twenty healthy subjects were recruited, and NoraxonTeleMyo 2400T was used to collect electromyographic signals from the LT, SA, and ES muscles. A two-way repeated analysis of variance (ANOVA) used a significance level of .05. If a significant interaction was found, pairwise comparisons were performed with a Bonferroni adjustment (.05/4=.013). The results of the study were as follows: 1) In LT, no significant ADIM by position interaction was found ($F_{1,19}$=.356, p=.558). There was a significant main effect for ADIM. LT muscle activity with ADIM was significantly greater compared with muscle activity without ADIM ($F_{1,19}$=82.863, p<.001). There was also a significant main effect for position. LT muscle activity in the prone position was greater compared with muscle activity in the standing position ($F_{1,19}$=116.401, p<.001). 2) In SA, significant ADIM by position interaction was found ($F_{1,19}$=8.687, p=.008). There were significant differences in all pairwise comparisons. The greatest SA muscle activity was observed in the standing position with ADIM. 3) In ES, significant ADIM by position interaction was found ($F_{1,19}$=122.473, p<.001). The lowest ES muscle activity was elicited in the standing position with ADIM. Based on these results, ADIM is advocated in the prone position to increase LT muscle activity. In addition, it is concluded that arm lifts in the standing position with ADIM offer the most favorable combination for reducing ES muscle activity and increasing SA muscle activity.