• Physical Therapy Korea
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• v.31 no.1
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• pp.55-62
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• 2024

Background: The serratus anterior (SA) is a muscle that performs protraction of the scapulothoracic joint and plays a role in stabilizing the scapula. Imbalances or weaknesses in SA activation are associated with a variety of shoulder dysfunctions, making selective SA strengthening important for rehabilitation. Objects: We aimed to compare the muscle activation of the pectoralis major (PM), SA, external oblique (EO), and internal oblique (IO) during the push-up plus (PUP) exercise with isometric hip adduction (HA) and abdominal drawing-in maneuver (ADIM). Methods: Nineteen healthy male participants performed three PUP exercises: standard PUP, PUP with ADIM, and PUP with HA. Surface electromyography was used to measure and analyze the muscle activity for PM, SA, EO, and IO. Results: PUP with HA showed the lowest PM activity and highest SA activity, and no significant difference was observed between PUP and PUP with ADIM. PUP with ADIM showed significantly the highest EO and IO activity, followed by PUP with HA and PUP. Additionally, PUP with HA showed the lowest PM/SA ratio, and no significant difference was noted between PUP and PUP with ADIM. Conclusion: PUP with HA was able to show high SA muscle activity while reducing PM muscle activity. In addition, PUP with HA can lead to higher EO and IO muscle activity than standard PUP. This exercise could be used as a practical exercise method to selectively strengthen SA and improve scapular muscle stability during early shoulder rehabilitation.

• Physical Therapy Korea
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• v.26 no.4
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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.

• Journal of Korean Physical Therapy Science
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• v.25 no.1
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• pp.62-74
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• 2018

Background: The purpose of this study is intended to evaluate the effectiveness and analyse the change on flexibility, muscular volume and pain of university students with low back pain by stabilization exercise using XCO. Methods: The subjects(N=23) with low back pain are recruited from K university located Chungbuck. The subjects which are divided to 2 group as experimental group(N=12) conducted the stabilization exercise using XCO and control group(N=11) conducted the general stabilization exercise. The flexibility, muscular volume and pain were measured before and after intervention. Results: There were no significant differences(p>.05) in sex, age, height and weight among subjects. Also there were no significant differences(p>.05) in muscular volume and pain between of the experimental group and control group. A significant difference(p<.05) in the flexibility, contraction EO(External Oblique), contraction IO(Internal Oblique), contraction TA(Transverse Abdominal) and pain in the experimental group. There was significant difference(p<.05) in the flexibility, contraction EO(External Oblique), contraction IO(Internal Oblique) and pain in the control group. There was a significant difference(p<.05) in the flexibility of the experimental group between the control group. Conclusion: Based on this study, through a variety of age and various intervention period to apply more subjects conducting Stabilization exercise using XCO should continue.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.210-214
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• 2016

Objective: The aim of this study was to measure the muscle architectural parameters of abdominal muscles in healthy individuals by rehabilitative ultrasound imaging (RUSI) and to investigate their changes after bridging exercise in various environments. Design: Cross-sectional study. Methods: The study included 40 healthy participants (19 men, 21 women). Subjects were randomly allocated to a stable surface group (SG, n=20) or an unstable surface group (UG, n=20). The participants assumed three positions in rest, bridging exercise with knee flexion $60^{\circ}$, and bridging exercise with knee flexion $90^{\circ}$ for the measurement of abdominal muscle thickness by RUSI. For the resting position, the participants held the head neutral in a hook-lying position and the dominant side was measured. For contraction, the participants performed the bridging exercise with the knee joint in $60^{\circ}$ and $90^{\circ}$ of flexion for 10 seconds each. Results: For transversus abdominis, external oblique muscle thickness, within the stable surface group and the unstable surface group, no significant contraction difference was observed in both the $60^{\circ}$ and $90^{\circ}$ bridge exercise conditions. Contraction difference of internal oblique muscle was significantly larger at $90^{\circ}$ than at $60^{\circ}$ within the SG (p<0.05). But within the UG, no significant contraction difference was shown. There was no significant contraction difference between the surface group and the unstable SG at $60^{\circ}$ condition and at $90^{\circ}$ condition in all measured muscles. Conclusions: The contraction difference is different for each muscle during bridge exercise with knee flexion $60^{\circ}$ and bridging exercise with knee flexion $90^{\circ}$. Muscle contraction difference is generally large when exercised on an unstable surface than a stable surface, but these are not statistically significant when bridging exercise is performed using dynamic air cushion for unstable surface.

• PNF and Movement
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• v.12 no.1
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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.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.2
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• pp.67-80
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• 2013

Purpose : This study was to investigate effects of closed kinetic chain and open kinetic chain exercise on the lumbar stabilizarion. Methods : A total of 30 healthy over 20 years old college students(men = 14, women = 16) who were participated in this. We selected randomly people of CKC, OKC, and control group. For the past four weeks, CKC and OKC group worked out 3 times per week and then we compared within group and between groups on muscle width. Results : 1. The width of internal oblique, transverse abdominis, and multifidus were all significantly increased after four weeks exercise in the CKC group(P<.05). 2. The width of internal oblique, transverse abdominis, and multifidus were all increased after four weeks exercise in the OKC group but transverse abdominis musule only showed significant difference. 3. Difference values between pre-exercise and post-exercise of transverse abdominis and multifidus in the CKC group was significantly high and difference among the groups were significant. Conclusion : Accordingly, lumbar stabilizing exercise was more effective to increase a width of abdominal deep muscles through CKC exercise.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.136-144
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• 2022

Objective: This study was to identify the effect of pressure biofeedback applied in various postures that allow the application of abdominal drawing-in. Design: A cross sectional study. Methods: The study intended to compare changes in the thickness of abdominal muscles between different postures when abdominal drawing-in was performed using a pressure biofeedback unit in five postures and to compare differences in terms of measures such as the transverse abdominis's preferential activation ratio(PAR). Data measured from 30 healthy individuals were used for data analysis. A paired t-test and repeated measures analysis of variance was performed to compare the thickness of each abdominal muscle. Results: The transverse abdominis's and internal oblique's thickness showed statistically significant differences in all postures when abdominal drawing-in (p<0.05). In the comparison between the postures, statistically significant differences were observed between the positions of hook-lying and wall support standing and between supine and wall support standing and between hook-lying and sitting (p<0.05). In terms of the transverse abdominis's PAR in each posture, statistically significant differences were observed between hook-lying and quadruped, hook-lying and sitting, hook-lying and wall support standing, quadruped and supine, sitting and supine, as well as wall support standing and supine (p<0.05). Conclusions: When abdominal drawing-in using pressure biofeedback unit is performed for stabilization exercises, selecting and applying specific postures according to targeted muscles and the subject's functional ability will help provide a more efficient and accurate intervention.

• Physical Therapy Korea
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• v.12 no.1
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• pp.1-10
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• 2005

The purpose of this study was to verify the most effective spinal stabilization exercises program by comparing the activities of muscles contributing to spinal stabilization during four types of exercises using a sling and a mat. Twenty healthy males were recruited and each subjects performed four types of exercises. Exercise 1 was performed in a quadruped position with the subjects lifting the left arm and the opposite leg on the mat. Exercise 2 was performed in a prone position while holding a sling with the right hand and the left knee was fully extended while lifting the left arm and right leg. Exercise 3 was performed in quadruped position while holding a sling with one the right hand and lifting the opposite arm and leg. In exercise 4, subjects were instructed to maintain a balance push-up position while holding slings with both hands in 10 cm forward reaching with extended elbows. Electromyographic(EMG) activities were recorded from the multifidus, external oblique, internal oblique, abdominal rectus, and erector spinalis muscles during the exercises. The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary isometric contraction (MVIC) of each muscle. Repeated ANOVA and Bonferroni's tests were used to compare the differences in the muscle activity according to the types of exercise. The EMG amplitudes of all the muscles were significantly different according to the types of exercises (p<.05). The highest EMG activities of each muscle was as follow; multifidus was 73.38%MVIC in exercise 3, the erector spinalis was 40.03%MVIC in exercise 3, the external oblique was 135.88%MVIC in exercise 4, the internal oblique was 128.60%MVIC in exercise 4, and the rectus abdominalis was 95.24%MVIC in Exercise 4. The types of exercises showed a significant difference in composition rate of EMG amplitudes of each muscle (p<.05). EMG composition rate of the multifidus was high in exercise 1 and 3. However, EMG composition rates of the external oblique, internal oblique, and the rectus abdominals were high in exercise 2 and 4. These results showed differences in EMG activities of muscles contributing to trunk stabilization during different therapeutic exercises. Therefore, the type of exercise should be carefully selected to effectively strengthen a specific trunk stabilizer.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.1
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• pp.91-98
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• 2018

Purpose : The aim of this study is to determine changes to the thickness of core muscles, e.g., transversus abdominis (TrA), external oblique (EO), and internal oblique (IO), after plank and Kegel exercises and to compare the effects of the two exercise methods. Method : The study divided men and women in their 20s into two groups, Kegel and plank, by randomly allocating 30 males and 30 females to the targeted groups. To achieve the purpose of this study, we examined the thickness of core muscles after the participants performed plank or Kegel exercises. Results : 1. In the Kegel group, abdominal muscle thickness increased with time, and there was a statistically significant difference in the thickness of the TrA. 2. In the plank group, abdominal muscle thickness increased with time, and there was a statistically significant difference in the thickness of the TrA. 3. After the experiment, muscle thickness of the abdominal muscles in the plank exercise group were higher, but there was no significant difference between the Kegel exercise group and the plank exercise group. Conclusion : Both plank and Kegel exercises are recommended for core muscle stabilization, and based on the results of this study, Kegel exercise is either used as a core stabilizing exercise or as a plank exercise for the weaker patients or women.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.83-91
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• 2016

PURPOSE: There are several methods, such as the abdominal drawing-in maneuver (ADIM), maximal expiration (ME), and Kegel exercise, to strengthen the core muscles. However, to date no study has been conducted to compare the effects of the ADIM, ME, and Kegel exercise on the transverses abdominis (TrA), internal oblique (IO), external oblique (EO), and pelvic floor muscles (PFMs). The purpose of this study was to find out which of the three aforementioned exercises is most effective for contracting the core muscles. METHODS: The thickness of the TrA, IO, EO and PFMs was measured by ultrasonographic imaging during the ADIM, ME and Kegel exercise in 34 healthy participants. RESULTS: There was the significant difference between ADIM and Kegel exercise in the thickness of the TrA (p<0.05). There were the significant differences between ADIM and ME and between ME and Kegel exercise in the thickness of the IO and PFM (p<0.01). There was no significant activation in the thickness of the EO (p>0.05). Measurement reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). An ICC value of >0.77 indicated that reliability measurements was good. CONCLUSION: Kegel exercise was the most effective exercise for the TrA and the PFM, and ME was the most effective exercise for the IO muscles.