• Physical Therapy Korea
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• v.20 no.3
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• pp.81-88
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• 2013

Active straight-leg raise (ASLR) is a physical evaluation procedure to test lumbar spine stability. Several previous studies have reported various methods to control the activation of abdominal muscles during ASLR. We investigated the effects of three different hip positions in frontal plane on abdominal muscles to increase or decrease the difficulty level of lumbar spine stability exercise during ASLR in pain free subjects. Eleven young and healthy subjects voluntarily participated in this study (6 men, 5 women; mean age=$24.0{\pm}1.2$ years, height=$160.0{\pm}7.3cm$, weight=$55.0{\pm}10.6kg$, body mass index=$21.5{\pm}2.3kg/m^2$). The subjects had three trials on each ASLR with hip $10^{\circ}$ adduction, neutral hip, and hip $30^{\circ}$ abduction. Separate repeated-measures analysis of variance (ANOVA) and the post hoc Bonferroni tests (with ${\alpha}$=.05/3=.017) were performed for each muscle among the three different hip positions in frontal plane (ASLR with hip $10^{\circ}$ adduction, neutral hip, and hip $30^{\circ}$ abduction). The ipsilateral external oblique (EO), contralateral EO, ipsilateral internal oblique/transverse abdominis (IO/TrA), and contralateral IO/TrA were significantly greater in ASLR with hip $30^{\circ}$ abduction compared with ASLR with hip $10^{\circ}$ adduction. Also, the ipsilateral EO, contralateral EO, and ipsilateral IO/TrA were significantly greater in ASLR with hip $30^{\circ}$ abduction compared with ASLR with neutral hip. These results suggest that ASLR with hip $30^{\circ}$ abduction and neutral would be useful method to strengthen the EO and IO/TrA. And, ASLR with hip $10^{\circ}$ adduction would be effective in early stages of lumbar stabilization program due to low activation of EO and IO/TrA during maintaining of ASLR position with low load.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.736-741
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• 2010

Purpose: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap. Methods: From August 2008 to June 2009, 4 cases of thoraco-abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly. Results: Their mean age, 55.7 years and the average follow-up interval was 9 months. Patients' oncologic status ranged from stage IIIc to stage IV, it was classified according to the TNM staging system. Flap dimensions ranged between $15{\times}15$ and $25{\times}25\;cm$. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap. Conclusion: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single-stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.1-9
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• 2023

BACKGROUND: The purpose of this study was to find out which exercise is more effective for the activation of the trunk, when the suspension plank and modified bridge exercise are performed. Weakening of the trunk muscles can lead to secondary injuries such as back injuries. In order to prevent injury, trunk muscles must be strengthened, and representative trunk strengthening exercises include planks and bridges. Each has been developed with a modified method, but since there is no paper comparing which exercise is more effective for trunk muscle strength, it was written to compare the two exercises. METHODS: The subjects were a random sample of 30 healthy men who agreed to participate in the study. The subjects were divided into two groups of 15 people each, and the suspension plank and the modified bridge exercise were performed for six weeks. The thickness of the transverse abdominis (TrA), internal abdominal oblique (IO), external abdominal oblique (EO), rectus abdominis (RA), multifidus (MF) was measured before and after the exercise. The two groups were analyzed using an independent t-test and paired t-test to compare the muscle thickness and the difference before and after exercise. RESULTS: The trunk muscle thickness was increased in both groups with suspension plank and modified bridge exercise, and there was a statistically significant difference. When comparing the two groups, the suspension plank group also showed a significant difference in RA (p<.05). CONCLUSION: As a result of this study, suspension plank exercise can have a positive effect on activating the trunk muscles and strengthening the strength of RA. Therefore, it is considered that suspension plank exercise is a more effective intervention to strengthen trunk muscle than modified bridge exercise.

• 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.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.375-378
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• 2018

In this report, we present a case of successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug. A 70-year-old man underwent total gastrectomy and developed anastomotic leakage and dehiscence of the abdominal wound a week later. He was dependent upon extracorporeal membrane oxygenation, continuous hemodiafiltration, and a respirator. Bowel fluids contaminated the open abdomen. Two months after the gastric operation, a plastic surgery team, in consultation with general surgeons, performed perforator flaps on both sides and constructed, as it were, a bridge of skin sealing the orifice of the fistula. The aponeurosis of the external oblique muscle was elevated with the flap to be used as a plug. The perforators of the flaps were identified on preoperative and intraoperative ultrasonography. This modality allowed us to locate the perforators precisely and to evaluate the perforators by assessing their diameters and performing a waveform analysis. The contamination decreased dramatically afterwards. The bare areas were gradually covered by skin grafts. The fistula was closed completely 18 days after the perforator flap. An ultrasound-guided perforator flap with an aponeurosis plug can be an option for patients suffering from an open abdomen with a bowel fistula.

• Physical Therapy Korea
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• v.25 no.1
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• pp.22-30
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• 2018

Background: Improvement of lumbo-pelvic stability can reduce the compensatory action of the quadratus lumborum (QL) and selectively strengthen the gluteus medius (GM) during side-lying hip abduction (SHA). There are abdominal draw-in maneuver (ADIM) and abdominal bracing (AB) as active ways, and pelvic compression belt (PCB) as a passive way to increase of lumbo-pelvic stability. It is necessary to compare how these stabilization methods affect the selective strengthening of the GM. Objects: To investigate the effects of ADIM, AB, and PCB during SHA on the electromyography (EMG) activity of the GM, QL, external oblique (EO) and internal oblique (IO), and the GM/QL EMG activity ratio. Methods: A total of 20 healthy male adults participated in the study. The subjects performed three conditions in side-lying in random order: SHA with ADIM (SHA-ADIM), SHA with AB (SHA-AB), and SHA with PCB (SHA-PCB). To compare the differences among the three conditions, the EMG activities of the GM, QL, EO and IO, and GM/QL EMG activity ratio were analyzed using one-way repeated ANOVA. Results: The EMG activity of the QL was significantly higher in SHA-AB than in SHA-ADIM and SHA-PCB. The GM/QL activity ratio was significantly higher in SHA-PCB than in SHA-ADIM and SHA-AB. In addition, the figure for SHA-ADIM was significantly higher than that for SHA-AB. In the case of the EO, the figure for SHA-AB was significantly higher than corresponding values for the other two conditions. The figure for SHA-ADIM was significantly higher than that for SHA-PCB. The EMG activity of the IO was significantly higher in SHA-AH than in SHA-PCB. Conclusion: It can be suggested that wearing the PCB can more selectively strengthen the GM than to perform ADIM and AB during SHA. In addition, the ADIM can be recommended when there is a need to strengthen abdominal muscles during SHA.

• Journal of Digital Convergence
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• v.18 no.2
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• pp.483-487
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• 2020

In this study, the effects of suspension training according to the types of ground. Fourteen healthy male college students measured for the characteristics of core muscle activity in suspension training on two different types of grounds, normal flat and unstable ground using a gym ball. EMG (Electromyography) was exploited to measure the activity of the core muscles according to the types of the ground. Muscle activity of the abdominal muscles, external oblique muscles, internal oblique muscles, and lower lumbar standing muscles was measured. The variables in analyses were measured by the means of % MVC method to standardize the EMG signal according to the ground type for each core muscle. In order to verify the differences in core muscles according to the type of ground the paired t-tests were performed at the significance level of 0.05 (p<.05). As a result of measuring the activity of the core muscles according to the various types of grounds, the difference between muscle characteristics obtained in two different grounds did not appear to be statistically significant. However, the result is an important clue to reconsider the notion that the training effect on the unstable ground is generally superior to the effect on the stable ground in the core muscle training. The type of ground in the core muscle training has been found not to significantly affect the muscle activation according to the results of this study. Regardless of the type of exercise program, hence, the difference in muscle activation will not be insignificant even with the standardized program strengthening core muscles.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.214-221
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• 2023

Objective: This study aimed to assess the impact of using the LED light electromyographyfeedback system (EMG-light) during Pilates exercises in women to maintain consistent muscle contraction in the abdominal external oblique muscles and reduce muscle contraction in the upper trapezius muscles. This study compared Pilates training using the EMG-light with Pilates training only in healthy women for 4 weeks. Design: This study was conducted as a cross-sectional study. Methods: A total of 17 healthy women were divided into an experimental group (n=9) and a control group (n=8). Both groups performed Pilates exercises as assigned, twice per week for four weeks, with each session lasting fifty minutes. The experimental group were used the EMG-light feedback system during pilates exercise while the control group did not use EMG-light. We used cervical vertebral angle (CVA), shoulder tilt angle to evaluate neck posture and standing balance with closed eye for 30s before and after exercise. Results: The control group exhibited a significant change in CVA (p<0.05). Both groups showed significant changes in shoulder tilt, center of pressure (COP) path-length, and COP velocity during eyes-closed conditions (p<0.05). However, there were significant differences between the experimental and control groups in terms of CVA, shoulder tilt, COP path-length, and COP velocity. Conclusions: This study demonstrated that Pilates exercises had positive effects on shoulder posture and balance. The use of EMG-light provided real-time visual feedback on muscle contraction during Pilates exercise. However, the experimental group did not show significant improvements compared to the control group, which performed Pilates exercises without feedback.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.410-417
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• 2006

The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.114-120
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• 2007

The augmentation of soft tissue defects is one of the critical problems in the oral and maxillofacial surgery. Various types of graft materials, both autologous and non-autologous, have been used for the augmentation of soft tissue in the facial region. However, it is not easy to choose an ideal material for soft tissue augmentation because each has its advantages and disadvantages. An ideal graft material should meet the following criteria : it should not leave a scar at the area from which it was taken; should have less likelihood of causing infection; should feel natural after implanted; and should be not absorbed. Among the materials meeting these criteria, human dermis and artificial dermis are commonly used for clinical purposes. The present study was aimed to investigate and compare the resorption rate and the histological change following the use of the autologous dermis, the human homogenous dermis $Alloderm^{(R)}$, and the artificial dermis $Terudermis^{(R)}$ to reconstruct the soft tissue defect. Twenty mature rabbits of either sex, weighing about 2 ㎏, were used. Each rabbit was transplanted with the autologous dermis, $Alloderm^{(R)}$, and $Terudermis^{(R)}$ size $1{\times}1-cm$ at the space between the external abdominal oblique muscle and the external abdominal oblique fascia. They were then divided into 4 groups (n=5 each) according to the time elapsed after the surgery: 1, 2, 4, and 8 weeks. The resorption rate was calculated by measuring the volume change before and after the transplantation, and H-E stain was preformed to observe the histological changes. The resorption rate after 8 weeks was 21.5% for the autologous dermis, 16.0% $Alloderm^{(R)}$, and 36.4% $Terudermis^{(R)}$, suggesting that $Alloderm^{(R)}$ is the most stable while $Terudermis^{(R)}$ is the most unstable. In microscopic examinations, the autologous dermis graft was surrounded by inflammatory cells and showed foreign body reactions. The epidermal inclusion cyst was observed in the autologous dermis graft. $Terudermis^{(R)}$ and $Alloderm^{(R)}$ demonstrated neovascularization and the progressive growth of new fibroblast. The results suggest that $Terudermis^{(R)}$ and $Alloderm^{(R)}$ can be availably for substituting the autologous dermis.