• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.45-64
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• 2003

The purpose of this study was to examine the effects of the pelvic tilting exercise, pelvic tilting exercises with floor walking training, pelvic tilting exercises with treadmill walking training on quantitative gait function in patients with hemiplegia. Thirty patients with hemiplegia due to cerebrovascular disease participated in this study. Subjects were randomly assigned to one of pelvic tilting exercise group, pelvic tilting exercise with floor walking training group and pelvic tilting exercises with treadmill walking training group. The effects of each therapeutic method were evaluated by measurements of gait velocity, cadence, stride length, step length, base of support and foot angle using ink-foot prints. Data were analyzed statistically using paired t-test and one-way ANOVA. The results of this research are as followings : 1. After treatment, it turned out that pelvic tilting exercises with treadmill walking training has the most effect on gait velocity, cadence, stride length, step length and foot angle, which has significant difference in statistics (p<0.05). 2. Quantification of the gait velocity, cadence, both stride length and step length demonstrated a significant increase (p<0.05) after treatment in all groups when compared with values measured before treatment. The base of support and foot angle in affected side decreased significantly (p<0.05) after treatment in all groups when compared with values measured before treatment. 3. The lumbosacral angle noted a significant increase (p<0.05) after treatment in all groups, however, an ANOVA analysis did not reveal any differences between groups.

• Physical Therapy Korea
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• v.17 no.4
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• pp.16-25
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• 2010

The aim of this study was to determine the muscle activity of the abdominalis and erector spinae during bridging and unilateral bridging exercises on the firm surface, the sir-fit, and the foam roll. Eighteen healthy young subjects were recruited for this study. Surface electromyographic (EMG) activities were recorded from the both sides of the rectus abdominalis, external obliques, internal obliques, and erector spinae muscles during bridging and unilateral bridging-exercises. A one-way repeated analysis of variance was used to compare the EMG activity of each muscle according to the support surface condition. Differences in the EMG activities between the bridging and unilateral bridging exercises, and between the right and left side were assessed using a paired t-test. The study showed that the EMG activities of all of the muscles were significantly higher when the bridging exercise was performed using the foam roll or sit-fit than on the firm surface. The EMG activities of the right rectus abdominis, right external obliques, the right internal oblique, and both erector spinae were significantly higher during unilateral bridging ex exercise using the foam roll or the sit-fit than on the firm surface. The EMG activities of all of the muscles were significantly higher during the unilateral bridging exercise than during the bridging exercise. Based on these finding, performing the unilateral bridging exercise using the sit-fit or the foam roll is a useful method for facilitating trunk muscle strength and lumbar stability.

• Physical Therapy Korea
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• v.24 no.4
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• pp.60-67
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• 2017

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

• Physical Therapy Korea
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• v.21 no.2
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• pp.1-7
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• 2014

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.

• Physical Therapy Korea
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• v.21 no.3
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• pp.38-44
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• 2014

The aim of this study was to investigate the effects of different postural correction in the electromyographic (EMG) activity of the trunk and hip muscles during bridging exercises. Twenty-four healthy subjects volunteered for this study. The muscle activity was recorded with surface electrodes over the erector spinae, multifidus, gluteus maximus (GM), and hamstring (Ham) muscles; it was measured by using surface EMG equipment under the following 3 experimental conditions: manual postural correction, verbal correction, and no correction. The maximal voluntary isometric contraction (MVIC) was determined for each muscle group in order to represent each exercise as a percentage of MVIC and allow for standardized comparison between subjects. A one-way analysis of variance was used to determine significant differences in the EMG activities of each muscle between the 3 experimental groups. During bridging exercises, the manual postural correction on normalized EMG activity of the GM muscle during manual guiding was significantly higher than during verbal guiding and without guiding (p<.05). Furthermore, the GM/Ham ratio was significantly higher during manual guiding than during verbal guiding and without guiding (p<.05). These findings suggest that the activities of the hip and trunk muscles may be favorably modified with manual guiding during bridging exercises.

• PNF and Movement
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• v.14 no.2
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• pp.113-120
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• 2016

Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey's multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.

• Physical Therapy Korea
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• v.27 no.1
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• pp.87-92
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• 2020

Background: Bridging exercises are used to enhance the functional stability of the lumbopelvic region in clinical settings. Although most of the studies on bridging exercises have compared the complete activation of the trunk muscles, some recent studies have examined the functional stability of the trunk and the lumbopelvic region and assessed the appropriate recruitment of the local and global muscles during different task levels. Objects: The purpose of this study was to investigate the changes in muscle thickness in the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles during a common bridging exercise on an unstable surface and to determine whether these changes differ based on the surface used. Methods: Twenty-five healthy young adults (8 males, 17 females) were recruited. The subjects were randomly assigned to either the exercise progression with a sling bridge group or the ball bridging exercise progression group, each with three stages of increasing difficulty. Each position was measured three times with an ultrasonic diagnostic imaging system, and the mean values were recorded for analysis. Results: No significant differences were observed between the TrA, IO, or EO muscle thickness ratios between the sling and ball exercise groups (p > 0.05). There were also no significant differences in the EO muscle thickness ratios between the tasks irrespective of whether the sling or ball was used. However, the TrA and IO thickness ratios in both groups were significantly greater during stages 2 and 3 compared to stage 1. Conclusion: The results suggest that the use of slings and balls during bridging exercises is effective in activating the deep abdominal muscles.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.29-37
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• 2019

PURPOSE: Prone hip extension (PHE) has been used for assessment of lumbo-pelvic movement and strengthening exercise for weakness of the hip joint muscles in patients with chronic low back pain (CLBP). On the other hand, few studies have examined which are the best PHE exercises to activate the gluteus maximus (GM) selectively in physical therapy practice. To aim of this study compared the muscle activity of the GM, rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) during these four different prone hip extensions, PHE, PHE with quadriceps activation (PHEQA), PHE with ankle dorsiflexion (PHEAD), and PHE with ankle plantarflexion (PHEAP), in subjects with CLBP. METHODS: Nineteen subjects with low back pain participated in this study. Subject performed four PHE exercises and surface electromyography (EMG) was used to evaluate the muscle activity. Data were analyzed by one-way repeated-measures analysis of variance (${\alpha}=.05/3=.017$) and a Bonferroni adjustment was performed if a significant difference was found. RESULTS: The muscle activities recorded by EMG showed significant among the four exercises. The muscle activity of the GM increased significantly during PHEQA than during PHEAP (P=.012). CONCLUSION: PHEQA is the most effective exercise for eliciting greater GM muscle activation among the four PHE exercises in subjects with CLBP.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.133-140
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• 2021

Purpose: This study aimed to compare the relative muscle activity on the erector spinae, gluteus maximus, and hamstring, using a non-visual feedback bridge exercise and a visual feedback bridge exercise with a tension sensor and clinometer. Methods: Twenty-two healthy subjects participated in this study. The study subjects performed bridge exercises without visual feedback, bridge exercises using a tension sensor, and bridge exercises using an inclinometer in the supine position, and the muscle activity of the left and right erector spinae, gluteus maximus, and hamstring muscles was measured while maintaining isometric contraction during the bridge movement. Muscle activity was measured by using surface an electromyography equipment. To standardize the measured action potential of each muscle, the maximum voluntary isometric contraction was measured. The bridge exercise was repeated 3 times for 5s each. Using repeated analysis of variance, we compared the significant difference in EMG activity for each muscle between the three experiments, and all statistical processing was performed using SPSS version 26. The statistical significance level was set at α = 0.05. Results: During bridging exercises, the asymmetry of the muscle activity of the erector spinae and gluteus maximus during visual feedback guiding was lower than that during no visual feedback. However, there was no significant difference. Moreover, the asymmetry of the muscle activity of the hamstring muscles was significantly lower during tension sensor visual feedback than that during no visual feedback (p<0.05). Conclusion: These findings suggest that bridge exercise with visual feedback using a tension sensor and an inclinometer is effective in inducing symmetrical movement. When it is necessary to symmetrically adjust the weight load of both feet during the bridge exercise, it is effective to apply visual feedback using a tension sensor.

• Physical Therapy Korea
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• v.29 no.1
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• pp.11-18
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• 2022

Background: Muscle activities of gluteus maximus (GM) and hamstring (HAM) have important roles in the stability and mobility of the hip joint during various functional activities including bridge and prone hip extension exercises. Objects: The purpose of this study is to investigate muscle activities of GM, multifidus (MF) and HAM during three different bridge exercises in healthy individuals. Methods: Twenty healthy subjects were participated. Electromyography device was used to measure muscle activities of GM, MF and HAM. Each subject was asked to perform three different bridge exercises with hip abduction (0°, 15°, 30°) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Statistical significance was set at α = 0.01. Results: The muscle activity of GM was significantly different among three conditions (hip abduction 0°, 15°, 30°) (adjusted p-value [Padj] < 0.01). The muscle activity of GM was significantly greater during bridge exercise with hip abduction 30° compared to 0° and 15° (Padj < 0.01). There was no significant difference in the muscle activity of MF and HAM muscle (Padj > 0.01). The ratio of muscle activity (ratio = GM/HAM) during bridge exercise with hip abduction 30° was significant greater compared to the hip abduction angles 0° and 15° (Padj < 0.01). Conclusion: Bridge exercise with hip abduction 30° can be recommended to selectively facilitate the muscle activity of GM and improve the ratio of muscle activity between GM and HAM.