• 한국전문물리치료학회지
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• 제26권4호
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• pp.42-52
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• 2019

Background: Whole body-electromyostimulation (WB-EMS) is widely used for the rehabilitation and recovery of patients with various neuromusculoskeletal disorders. Objects: To objectively measure changes in lower extremity and abdominal muscles after sit-to-stand dynamic movement training using WB-EMS. Methods: A total of 46 healthy adults (23 experimental and 23 control subjects) performed sit-to-stand exercise; the experimental group with WB-EMS, and the control group without WB-EMS. The muscle activity of the lower extremity, and the muscle thickness of the lower extremity and abdominal muscles were measured before and after the intervention. Results: In terms of electromyographic activity, there was a significant interaction effect for the rectus femoris (RF) muscle (F=30.212, p=.000). With regards to ultrasonographic imaging, the muscle thickness of the RF muscle had a significant interaction effect at the muscle contraction ratio (F=8.071, p=.007). The deep abdominal muscles, such as the transverse abdominal (TrA) and internal oblique (IO) muscles, also showed significant interaction effects at the muscle contraction ratio (F=5.474, p=.024, F=24.151, p=.000, respectively). Conclusion: These findings suggest that WB-EMS may help to improve the muscular activity of the RF muscle, and the muscle thickness of the RF muscle and deep muscles such as the TrA and IO muscles.

• 대한물리의학회지
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• 제5권3호
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• pp.405-412
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• 2010

Purpose : The purpose of this study was to assess the effects of the trunk muscle activity on bridging exercise according to the knee joint angle. Methods : Twenty-five healthy adults volunteered to participate in this study. Subjects were required to complete following four bridging exercises; knee joint flexion $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. Muscle activity was measured by QEMG-4 system(LXM 3204, Laxtha Korea). A repeated measures of one-way ANOVA with post-hoc Bonferroni's correction was used to determine the influence of bridging exercise on muscle activity for each muscle and descriptive statistics was used to determine local/global muscle ratio. Results : The internal oblique of bridging exercises $120^{\circ}$, $90^{\circ}$ showed significantly(p<.05). The erctor spinae of all bridging exercises showed significant excepted between $60^{\circ}$ and $45^{\circ}$(p<.05). Median of internal oblique/rectus abdominis ratio of $120^{\circ}$ was 4.41, $90^{\circ}$ was 3.94, $60^{\circ}$ was 3.58, $45^{\circ}$ was 3.39. Median of internal oblique/external oblique ratio of $120^{\circ}$ was 2.66, $90^{\circ}$ was 2.43, $60^{\circ}$ was 2.87, $45^{\circ}$ was 2.64. Conclusion : Angular motion decreasing with knee joint flexion made erector spinae activation increase. on the other hand, as decreasing abdomen muscle activation, the more performing motor learning is required for abdomen muscle strength and co-contraction for the trunk stabilization.

• 대한물리의학회지
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• 제7권3호
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• pp.275-282
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• 2012

Purpose : Bridge exercise has been commonly used in clinical rehabilitation settings to improve trunk control, and hip adductor muscles were a related muscle that may affect trunk muscle activation. The aim of this study was to investigate whether the co-contraction of hip adductor muscles may affect trunk muscle activation during bridge exercises. Methods : Thirty-eight healthy young subjects (19 men and 19 women) performed bridge exercises (with and without hip adduction movement). Surface electromyography (EMG) data were collected from the dominant-side internal oblique (IO), rectus abdominis (RA), multifidus (MF) and erect spine (ES) during bridge exercises to compare trunk muscles activation patterns. Result : The EMG activities of IO and RA appeared to be significantly higher during bridge exercise with hip adductor co-contraction than during bridge exercise alone (p<.01), but there were no significant differences in those of MF and ES. Furthermore, there were significant differences in the IO:RA EMG ratio during bridge exercise with hip adductor co-contraction (p<.05). Conclusion : These findings suggest that integration of hip adduction during bridge exercise may be beneficial in increasing deep muscles' activity for trunk stabilization.

• PNF and Movement
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• 제15권1호
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• pp.51-56
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• 2017

Purpose: The purpose of this study was to examine the effects of the PNF stabilization technique for the hip joint and the bridging exercise on the trunk stabilizer muscles in healthy adults. Methods: Twenty-eight healthy adults were randomly allocated to either a PNF stabilization exercise group (n = 12) or a bridging exercise group (n = 16). The outcome measures included the contraction thickness ratio in the transversus abdominis (TrA), internal oblique (IO), and external oblique (EO), and the TrA lateral slide was assessed during the abdominal drawing-in maneuver using b-mode ultrasound. The researcher measured the abdominal muscle thickness of each participant before the therapist began the intervention and at the moment that the intervention was applied. Between-group comparisons were performed using the Mann-Whitney U test. The level of statistical significance was set at 0.05. Results: The PNF intervention program showed a significant increase in the trunk stabilizer muscle. The percentage of change in the TrA thickness showed a significant interaction between intervention. However, there were no significant differences in the IO and EO between the two groups. Conclusion: The PNF stabilization technique for the hip joint can be used effectively to improve the IO and TrA muscles in healthy adults.

• PNF and Movement
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• 제12권1호
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• pp.39-43
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• 2014

Purpose: This study was to examine lateral abdominal muscle activation during maximum expiration exercise between healthy and chronic low back pain(CLBP) patients. Methods: The subjects were 16 CLBP patients and 16 healthy people between the ages of 22 and 53. The thickness of the abdominal muscles was measured using ultrasonography(LOGIQ Book XP, GE, USA). We instructed the subjects how to perform the exercises and measured changes in thickness of the transversus abdominis(TrA) and internal oblique(IO) muscles during the maximum expiration. The main outcome variables were the ratios of the TrA and IO thickness during the exercise versus in the relaxed position(TrA and IO activation ratios). Results: There were significant differences between CLBP patients and healthy subjects for TrA in the relaxed position. However there was no difference in the ratio of change in the muscle activity(TrA, IO). Conclusion: These findings, CLBP patients exhibited atrophy of the TrA muscle, but voluntary TrA muscle activation was similar to that of the normal subjects. Therefore, this exercise could be used during core strengthening in CLBP patients.

• 한국전문물리치료학회지
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• 제19권3호
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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.

• 대한물리의학회지
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• 제15권1호
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• pp.77-84
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• 2020

PURPOSE: This study compared the activities of the trunk muscles during crutch walking to determine which of the crutch length measurements is most beneficial. METHODS: Twenty young women volunteered to participate in this study. After adjusting crutch length, the participants performed a three-point walking with nondominant leg limited in weight bearing. This study used six crutch length measurements: (1) Height-40.6cm, (2) Height'.77, (3) Olecranon-to-finger length, (4) Axillary-toheel length, (5) Arm-span length-40.6cm, and (6) Arm-span length'.77. The EMG activities of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES), muscles on the weight bearing side were monitored using wireless surface EMG. RESULTS: The EMG activities of the RA and ES appeared to be significantly different among the crutch length measurements (p<.05). The post-hoc test showed that the 'Arm-span length-40.6cm' was significantly greater in the RA activity when compared to the 'Height'.77' and 'Axillary-to-heel length' measurements, and in the ES activity when compared to 'Height'.77' measurements. Furthermore, IO/RA and MF/ES ratios showed significant differences among the crutch length measurements (p<.05). In the post-hoc test, significant difference was observed between 'Olecranon-to-finger length' and 'Arm-span length-40.6cm' for the IO/RA ratio, and between 'Height'.77' and 'Olecranon-to-finger length' and between 'Height'.77' and 'Arm-span length-40.6cm' measurement for the MF/ES ratio. CONCLUSION: These findings suggest that the 'Height'.77' measurement is relatively advantageous to optimize the activities of trunk muscles during the crutch walking, and allow simple measurements of the crutch length.

• 대한물리의학회지
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• 제7권3호
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• pp.319-327
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• 2012

Purpose : This study aimed to identify the asymmetry observed in the rehabilitative ultrasound imaging of lateral abdominal muscle thickness and performance between the affected and unaffected side during the abdominal drawing-in maneuver (ADIM), an exercise used to facilitate activation of selectively TrA to stabilize the trunk prior to limb movement. Methods : The Participants were twenty one patients with post-stroke hemiplegia in this study. Ultrasound imaging was used to measure amount of changes in thickness of the external oblique (EO), internal oblique (IO), transversus abdominis (TrA). A Paired t-test was used to compare relaxed muscle thickness to contracted muscle thickness of all 3 muscles between the affected and unaffected sides. Results : The outcome measures included side to side differences of absolute thickness, contraction ratio among the lateral abdominal muscles. There was no significantly difference in between the affected and unaffected side at rest. But, there was a significantly difference in absolute muscle thickness between the affected and unaffected side of only TrA muscle. Also contraction ratio was a significantly difference between the affected and unaffected TrA muscle. Conclusion : These findings support the asymmetrical activation of TrA muscle during abdominal muscle contraction in patients with post-stroke hemiplegia. Further studies are warranted for confirming this outcome.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.112-118
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• 2016

Purpose: This study examined thickness changes in abdominal muscles according to difficulty level of core stabilization exercise in healthy subjects. Methods: Thirty healthy subjects (age range: 21-30 years) volunteered under three conditions. In the first condition, the subjects performed an abdominal draw-in maneuver (ADIM). In the second condition, they performed the ADIM during quadruped exercise using a suspension device without extending their lower limbs. In the third condition, the subjects performed the ADIM during quadruped exercise using a suspension device while extending both lower limbs. The changes in thickness of transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were measured by ultrasonography (US) imaging during the three experimental conditions, and US was used to measure the improvement ratio of muscle thickness at rest. The interventions were conducted over three trials in each condition, and measurements were performed on each subject by one examiner. Results: Our results showed a significantly greater increase in the muscle thickness of TrA and IO muscles after performance of quadruped exercise using a suspension device without knee extension (p<0.05) compared to the other conditions. The results also showed a significantly greater increase in the thickness changes of EO muscle in those who performed the ADIM during quadruped exercise using a suspension device with knee extension (p<0.05) compared with the ADIM only. Conclusion: These findings demonstrated positive evidence that a low-level core stabilization exercise could improve thickness of abdominal muscles.

• 한국전문물리치료학회지
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• 제20권4호
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• pp.1-8
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• 2013

This study analyzes how different knee flexion angles affect the abdominal and pelvic muscle activity during supine bridging. Twenty healthy subjects participated in the study. We used surface electromyography (EMG) to measure how three different knee flexion angles ($100^{\circ}$, $70^{\circ}$, and $40^{\circ}$) affected the activity of the transverse abdominis/internal oblique (TrA/IO), external oblique (EO), biceps femoris (BF), rectus femoris (RF), and gluteus maximus (GM) muscles on the dominant side during supine bridging. The one-way repeated analysis of variance (ANOVA) was used to determine the statistical significance of TrA/IO, EO, BF, RF and GM muscle activity and the GM/BF activity ratio. For the TrA/IO, EO, BF, and GM muscles, supine bridging with different knee flexion angles resulted in significant differences in abdominal and pelvic muscle activity. For the TrA/IO muscles, the post-hoc test demonstrated that muscle activity significantly increased at $40^{\circ}$ compared to $70^{\circ}$; however, there were no significant differences between $100^{\circ}$ and $70^{\circ}$ or $100^{\circ}$ and $40^{\circ}$. For the EO muscle, the post-hoc test demonstrated that muscle activity significantly increased at $40^{\circ}$ compared to $100^{\circ}$ and $70^{\circ}$; no significant difference was observed between angles $100^{\circ}$ and $70^{\circ}$. For the BF muscle, the post-hoc test demonstrated that muscle activity significantly increased according to the knee flexion angle ($40^{\circ}$ > $70^{\circ}$ > $100^{\circ}$). For the GM muscle, the post-hoc test demonstrated that muscle activity significantly increased according to the knee flexion angle ($100^{\circ}$ > $70^{\circ}$ > $40^{\circ}$). However, for the RF muscle, there was no significant difference. Additionally, the GM/BF activity ratio significantly increased according to the knee flexion angle ($100^{\circ}$ > $70^{\circ}$ > $40^{\circ}$). From these results, we can conclude that bridging with a knee flexion of $100^{\circ}$ can strengthen the GM muscle, whereas bridging with a knee flexion of $40^{\circ}$ is recommended to strengthen the IO, EO, and BF muscles. We can also conclude that knee flexion angles should be modified during supine bridging to increase the muscle activity of different target muscles.