• Physical Therapy Korea
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• v.13 no.2
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• pp.61-69
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• 2006

The purpose of this study was to compare the electromyography (EMG) activities of the lumbar extensor muscles during motion of trunk flexion-extension and compare range of motion (ROM) with a 3-dimensional motion analysis system of the lumbar region between subjects with chronic low back pain (CLBP) and healthy subjects during the trunk flexion-extension, trunk rotation and trunk lateral flexion cycle. Thirty CLBP subjects and thirty healthy subjects were included. We measured the root mean square (RMS) value of the lumbar extensor muscles from resting, standing, lumbar flexion and return position. The RMS ratio was normalized from maximal EMG activity of the lumbar extensor muscles during trunk motion. The results of this study showed that the RMS ratio of the lumbar extensor was significantly higher in CLBP subjects than healthy subjects during all of trunk motion (p<.05). The ratio of the highest RMS value during flexion and extension was higher in CLBP subjects than in healthy subjects (p<.05). The ROM of the lumbar region was significantly lower in CLBP subjects than healthy subjects during trunk flexion-extension, trunk rotation and lateral flexion cycle. The relationship between the RMS ratio for full lumbar flexion and the ROM of lumbar flexion was not correlated significantly. CLBP subjects have both decreased ROM of the lumbar region and higher muscle activities of the lumbar extensor muscle than healthy subjects.

• Journal of Korean Physical Therapy Science
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• v.7 no.1
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• pp.353-365
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• 2000

The purpose of this study were to compare the lumbar extensor strength between pre op patients group and after 6 weeks post op patients group. To evaluate lumbar extensor strength of total 273 patients with HIVD. Lumbar extensor strength was measured in 151 male patients and 122 female patients(Lumbar extensor strength was measured in 91 PELD patients group and 182 OLM group patients) by Medx lumbar extension machine. Maximum voluntary lumbar extension strength was appear $149.36{\pm}61.92ft$-lbs in pre op of PELD group, $158.47{\pm}54.67ft$-lbs in post op of PELD group and $135.54{\pm}54.24ft$-lbs in pre op of OLM group. $147.19{\pm}52.42ft$-lbs in post op of OLM group in male. Maximum voluntary lumbar extension strength was appear $83.85{\pm}30.22ft$-lbs in pre op of PELD group. $92.99{\pm}28.66ft$-lbs in post op of PELD group and $75.16{\pm}24.98ft$-lbs in pre op of OLM group, $79.88{\pm}25.25ft$-lbs in post op of OLM group in female. Male and female lumbar extension strength was statistically significant difference(P<.05). Lumbar flexion/extension ratio of the two group was 2.14:1 pre op and 2.05:1 post op in lumbar flexion 72 and 0 degree. The ratio of post op group was lesser than pre op group.

• Korean Journal of Applied Biomechanics
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• v.17 no.2
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• pp.123-130
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• 2007

This study is that the elderly female patients having low back pain(34 people) show a change of stabilization ratio after isotonic rehabilitation of 4 types(before exercise, after 4weeks, 8weeks, 12weeks). Under the cover of lumbar extension machine, isometric extension strength and stabilization ratio is measured and analyzed at some flexion angles(the degree of $0^{\circ}$, $12^{\circ}$, $24^{\circ}$, $36^{\circ}$, $48^{\circ}$, $60^{\circ}$, $72^{\circ}$). The conclusion is as follows. 1. The maximum lumbar extension strength at a range of 7 angles have an increase of 73.92% in case of 12weeks isotonic exercise(p<.001). 2. After 12weeks exercise, the lumbar flexion angle maximum extension strength, have an higher increase than 54% on the average at all angles(p<.001). These statistically show a meaningful increase of muscular strength. 3. After 12weeks isotonic exercise, the lumbar stabilization ratio have a decrease of 50.27% at a statistically meaningful level(p<.001). In case of 12weeks exercise comparing with 8weeks, the stabilization ratio decrease at the level of 1.85 versus 1. This figure is similar to that of a normal person. In view of this study, 12weeks exercise for the elderly female patients having low back pain has much influence on the change of lumbar stabilization ratio and this is the scientifically verified result of a long term exercise.

• Physical Therapy Korea
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• v.18 no.3
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• pp.85-93
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• 2011

The purpose of this study was to establish the reliability and validity of the passive lumbar extension (PLE) test and prone instability test (PIT). Thirty-three subjects (14 males, 19 females) with lower back pain enrolled in the study and the subjects were divided into 2 groups (positive and negative instability groups) on the basis of radiographies of flexion and extension. Reliability was determined by the kappa coefficient and validity was examined using calculated sensitivity, specificity, and the likelihood ratio. The results showed that the reliability of the PLE test was higher than the PIT (intra-rater reliability: k=.86 and k=.81, interrater reliability: k=.65 and k=.62) and the validity of the PLE test was also higher than the PIT (sensitivity: 91% and 62%, specificity: 95% and 85% positive likelihood ratio: 20.00 and 4.10, negative likelihood ratio: .10 and .45). In conclusion, we think that the PLE test was a more reliable and valid method for lumbar instability than the PIT.

• Journal of Acupuncture Research
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• v.27 no.3
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• pp.93-104
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• 2010

Objectives : The purpose of this study is to observe the effects of work environment and low back pain on the structural and muscle strength changes in lumbar spine to helpful for preventation and cure of low back pain. Methods : Through measuring of lumbosacral angle, lumbar lordotic angle, lumbar gravity line ratio analyzed structure of lumbar spine and using Trunk Extension Flexion Program of CYBEX NORM System(cybex770+TMC, USA) analyzed Flex. PT, Ext. PT, E/F ratio of lumbar spine of company employees given a medical examination. Results : According to work environment, lumbar gravity line ratio is higher in white collar group than in blue collar group, Ext. PT is significantly lower in white collar group than in blue collar group. According to low back pain or not, lumbar gravity line ratio, Ext. PT is lower in low back pain group than in non-low back pain group. Conclusions : Work environment and low back pain effects on the structural and muscle strength changes in lumbar spine.

• PNF and Movement
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• v.19 no.3
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• pp.413-422
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• 2021

Purpose: This study was conducted to investigate changes in the cervical and lumbar flexion-relaxation ratio, range of motion, pressure pain threshold, and perceived comfort following the wearing of a trunk brace during smartphone watching. Methods: To calculate the number of subjects for this study, an analysis with G^*Power was performed at a statistical power of 0.8, an effect size of 0.5, and a significance level of 0.05, based on the results of a preliminary experiment on five subjects. In total, 27 adult men and women were recruited who had been informed of the study's purpose and process and had agreed to participate. All subjects watched content on a smartphone for 20 minutes in the same posture and conditions while wearing and not wearing a trunk brace, and then their cervical and lumbar flexion-relaxation ratio, range of motion, pressure pain threshold, and perceived comfort were measured. Results: Compared to the non-wearing of a trunk brace, the wearing of a trunk brace resulted in a statistically significant smaller decline in cervical extension and right-side cervical rotation (p<0.05). When the subjects wore a trunk brace, their right- and left-side cervical and right-side lumbar pressure pain statistically significantly improved when compared to not wearing a trunk brace (p<0.05). They also perceived a significantly lowered level of comfort 20 minutes after wearing a trunk brace compared to immediately after wearing it (p<0.05). Conclusion: The trunk brace was effective in reducing declines in right-side cervical rotation and the occurrence of left- and right-side cervical and right-side lumbar pressure pain. The findings indicate the need to improve the perceived comfort of trunk braces.

• Physical Therapy Korea
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• v.25 no.4
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.605-610
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• 2013

The purpose of this study is to examine the changes on lumbar muscle strength in relation to 12-week pilates mat exercise of elderly women. The participants are chosen for 17 people who is an experimental group and 14 people who is an comparison group who except wastage and pilates mat exercise program was gradually intensify applied three times a week, during 12 weeks. The peak torque of flexion was increased(p<.01) and the difference of ratio of agonist to antagonist was decreased(p<.001). The total work of flexion and extension had significant increased(p<.001) at $120^{\circ}/sec$. As a result of all these, it was judged as positive effect for body composition, basal physical fitness and lumbar muscle strength after pilates mat exercise in 12 weeks. These positive effects showed that pilates mat exercise could got conclusions that mitigated the musculoskelctal disorders, slow down the progress of disorders, helped as a functions of physical.

• Physical Therapy Korea
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• v.27 no.3
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• pp.171-177
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• 2020

Background: The flexion-relaxation phenomenon (FRP) refers to a sudden onset of activity in the erector spinae muscles that recedes or fades during full forward flexion of the trunk. Lumbar spine and hip flexion are associated with many daily physical activities that also impact trunk flexion. Shorter hamstring muscles result in a reduction of pelvic mobility that eventually culminates in low back pain (LBP). Many studies have explored the FRP in relation to LBP. However, few studies have investigated the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Objects: This study aimed to investigate the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Methods: Thirty subjects were divided into three groups according to hamstring length measured through an active knee extension test. The 30 participants consisted of 10 subjects who had a popliteal angle of 20° or less (Group 1), 10 subjects who had a popliteal angle of 21°-39° (Group 2), and 10 subjects who had a popliteal angle of 40° or more (Group 3). A one-way analysis of variance was used to compare the difference in muscle activity of the erector spinae muscles during trunk flexion. Results: The subjects with a shorter hamstring length had significantly higher muscle activity in their erector spinae muscles during trunk flexion and full trunk flexion (p < 0.05). The subjects with a shorter hamstring length also had a significantly higher flexion-relaxation ratio (p < 0.05). Conclusion: The results of this study demonstrate that differences in hamstring muscle length can influence the FRP in relation to the erector spinae muscles. This finding suggests that the shortening of the hamstring might be associated with LBP.

• Physical Therapy Korea
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• v.24 no.4
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• pp.1-10
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• 2017

Background: Flexion-relaxation phenomenon (FRP) was a term which refers to a sudden onset of myoelectric silence in the erector spinae muscles of the back during standing full forward flexion. Hamstring muscle length may be related to specific pelvic and trunk movements. Many studies have been done on the FRP of the erector spinae muscles. However, no studies have yet investigated the influence of hamstring muscle flexibility on the FRP of the hamstring muscle and lumbopelvic kinematics during forward bending. Objects: The purpose of this study was to examine the flexion-relaxation ratio (FRR) of the hamstring muscles and lumbopelvic kinematics and compare them during forward bending in subjects with different hamstring muscle flexibility. Methods: The subjects of two different groups were recruited using the active knee extension test. Group 1-consisted of 13 subjects who had a popliteal angle under $30^{\circ}$; Group 2-consisted of 13 subjects who had a popliteal angel above $50^{\circ}$. The kinematic parameters during the trunk bending task were recorded using a motion analysis system and the FRRs of the hamstring muscles were calculated. Differences between the groups were identified with an independent t-test. Results: The subjects with greater hamstring length had significantly less lumbar spine flexion movement and more pelvic flexion movement. The subjects with greater pelvic flexion movement had a higher rate of flexion relaxation during full trunk bending (p<.05). Conclusion: The results of this study suggest that differences in hamstring muscle flexibility might cause changes in people's hamstring muscle activity and lumbopelvic kinematics.