• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.1
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• pp.13-20
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• 2021

Background: The serratus anterior and upper trapezius muscles act synergistically to allow for an appropriate scapulothoracic rhythm. However, a decrease in serratus anterior activation causes the upper trapezius to become overactivated, resulting in dysfunction. This study compared serratus anterior and upper trapezius muscle activity according to sling angle and compared serratus anterior strength between healthy adults and patients with shoulder instability. Methods: Twenty participants (10 healthy adults and 10 patients with shoulder instability) were included in this study. The participants had their arms extended at sling angles of 30°, 60°, and 90° in reach forward with shoulder flexion using goniometer. Serratus anterior strength was measured three times while the participants were supine. The outcome measures were surface electromyography amplitude of the upper trapezius and serratus anterior and serratus anterior strength. Results: The Wilcoxon signed-rank test indicated that the upper trapezius was significantly different between healthy group and shoulder instability group at a sling angle of 60°, and both the upper trapezius and serratus anterior exhibited significant differences at 90°. Moreover, a significant difference was noted in the muscle strength of the serratus anterior. Conclusion: Our results provide novel and promising clinical evidence that patients with shoulder instability have decreased serratus anterior activation and upper trapezius overactivation, resulting in muscle imbalance. In addition, there was a significant difference between the healthy group and shoulder instability group in the serratus anterior muscle strength

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.8 no.2
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• pp.57-71
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• 2002

Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.253-261
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• 2013

PURPOSE: The Purpose of this study was to investigate the changes in the thickness of Sternocleidomastoid muscle(SCM) and deep cervical flexor muscle(DCF) through CranioCervical Flexion Exercise(CCFEx) Using Sling. METHODS: Subjects were randomly allocated two group: control group (n=21) without neck pain, experimental group (n=17) with pain. Muscle thickness was measured using CranioCervical Flexion Test(CCFT) and ultrasonography before or after intervention. RESULTS: In experimental group, compared with muscle thickness of exercise before, SCM thickness rate of change was slightly decreased according to pressure increased after exercise(p<.05). CONCLUSION: The results of this study showed that CCFEx using sling is effective for SCM and DCF of choric neck pain patients.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.173-180
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• 2018

Purpose: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. Methods: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. Results: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. Conclusion: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.

• Physical Therapy Korea
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• v.10 no.3
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• pp.29-40
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• 2003

The purpose of this study was to compare the muscle activity during a push-up on a suspension sling and a fixed support at the same level. Tests were performed on 15 male subjects. Electromyography using a surface EMG recorded the activity of the triceps, pectoralis major, and internal and external oblique muscles during each push-up. EMG activity was recorded at 0, 45, and 90 degrees of elbow flexion in the push-up position on a suspension sling or a fixed support at the same height above the floor (30 cm). The testing order was selected randomly. The subjects were asked to maintain the push-up position with straight knees, hips, and trunk for 5 seconds at each elbow angle. The mean root mean square (RMS) of EMG activity was calculated. EMG activity was normalized using the maximum voluntary isometric contractιn elicited using a manual muscle testing technique. Two-factor repeated measures analysis of variance (ANOVA) was used to compare the average RMS value of EMG activity for each condition. The EMG activity for the pectoralis major, and internal and external oblique muscles during a push-up on a sling was significantly higher than on a fixed support at all angles of elbow flexion (p<.01). There were significant differences in the EMG activity of the pectoralis major and triceps brachii muscles at difference angles of elbow flexion (p<.05). The pectoralis major muscle had the highest EMG activity at 90 degrees of elbow flexion on both the sling and fixed support. The triceps brachii muscle had the highest EMG activity at 45 degrees of elbow flexion on both the sling and fixed support. The internal and external oblique muscles had the highest EMG activity at 0 degrees of elbow flexion, although the difference with angle of flexion was not significant. These results suggest that to improve proximal and trunk stability and muscle strength, push-ups are more useful when performed on a suspension sling than On a fixed support.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.113-121
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• 2018

PURPOSE: This study was conducted to identify a more effective intervention in sling and resistance exercise for chronic low back pain patients. METHODS: Seventy (70) subjects were randomly divided into the sling group (SG) and resistance exercise group (REG). Muscular activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), and pelvic rotation angle during active straight leg raise (ASLR), a pressure pain threshold (PPT) and a visual analog scale (VAS) were measured. Sling and resistance exercises were conducted for 12 weeks. Intermediate measurements were taken after 8 weeks and final measurements were taken after 12 weeks. RESULTS: Both groups showed significantly decreased RA muscle activity and significantly increased IO muscle activity (p<.05). Additionally, EO muscle activity was significantly decreased in the REG, but significantly increased in the SG (p<.05), while the pelvic rotation angle and VAS were significantly decreased in the SG (p<.05). The pressure pain threshold was significantly increased in both groups (p<.05). CONCLUSION: Based on the results of this study, a 12-week intervention seems to be effective at improving back pain in both groups. However, a lower VAS was seen in the sling group after 8 weeks of intervention. Therefore, it is recommended that the sling be applied first when establishing a chronic back pain treatment program to shorten the treatment period and reduce the pain period.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1608-1613
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• 2018

The purpose of this study was to investigate the effects of sling exercise on muscle activity and balance on football players with chronic ankle instability. Eight subjects performed Biodex and sling exercises for four weeks and compared the muscle activity and balance ability of the uninjured and injured feet. Stable and unstable foot % MVIC did not change significantly after treatment in all muscles. The total balance ability was not significantly different between the two groups, however, increased only in the unstable side. The anterior/posterior balance ability also represented no significant difference between the groups and was significantly improved only in the unstable side. The medial/lateral balance ability was not significantly different between the groups and was significantly improved only in the unstable side. This study suggests that sling exercise contributes to improving % MVIC, total balance ability, anterior/posterior balance ability, and medial/lateral balance ability of the unstable side.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.51-58
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• 2016

Background: Evidence for effective management of scapular downward rotation syndrome is limited. The present study was performed to compare the scapular muscle activation through 4weeks wall slide exercise and sling slide exercise in subjects with scapular downward rotation syndrome. Methods: Twenty-two subjects with scapular downward rotation syndrome participated in the study. Surface electromyography data were collected from the upper and lower trapezius, serratus anterior and pectoralis major during shoulder flexion of $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ in the sagittal plane. The alignment of the scapula was measured using radiographic analysis. Subjects were assessed pre and post a 4 weeks exercise (wall slide, sling slide). The significance of the difference in pre- and post-exercise within each groups was assessed using a paired t-test. The significant difference between wall- and sling-exercise was used a independent t-test. Results: In the wall slide group, the muscle activity of upper trapezius decreased significantly during shoulder flexion at $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ after 4 weeks, and the muscle activity of serratus anterior increased significantly at all angles. Also, the muscle activity of pectoralis major decreased significantly at $90^{\circ}$ and $120^{\circ}$. Conclusions: Based on such results, it can be said that wall slide exercise is effective than sling slide exercise for the subjects with scapular downward rotation syndrome.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.39-45
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• 2018

Purpose : The purpose of this study is to investigate the effect of core motion pattern on abdominal muscle thickness on unstable support surface using sling suspension system and to provide an effective exercise program for therapeutic rehabilitation in clinical practice. Methods : In this study, we used the flank exercise using a sling. It was intended for 21 healthy men and 9 healthy women. Before and after the exercise of the subjects, abdominal muscles (EO, IO, TrA the thickness of the muscle) was determined using a diagnostic ultrasonic apparatus. The period of exercise was 3 times a week for 6 weeks. The exercise for each group started with 3 sets per week and 1 set per week was added. A description of the method and attitude of each exercise is as follows. First, the push-up flank 's exercise position is to put both feet on the sling and hold the floor with both hands. Second, the side flank's exercise postures take the side flanks, while the two legs hang on the sling and one arm supports the body with an articulated bend (about $90^{\circ}$). Third, the elbow flank's exercise position is to put the two legs on the sling, and take a flank posture with the arms bent and joint bending (about $90^{\circ}$). Results : There was a significant difference in the thickness of the muscle in the three flank movements after the exercise (p<.05). The most significant difference was in the change of the muscle thickness in the abdominal muscle, the outer muscle, and the stomach in the elbow flank exercise after exercise. There was a significant difference between the mean thickness of the abdominal muscles according to the flank type after exercise (p<.05). Conclusion : In flank exercise for core stabilization using sling, it is considered effective to strengthen the abdominal muscles by considering the support surface, difficulty level, change of movement pattern.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.57-69
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• 2022

Purpose : The purpose of this study was to investigate the effect of ankle strengthening exercise combined with sling-assisted gluteus medius strengthening on ankle instability score, and static and dynamic balance ability, muscle strength in adults in their 20s with chronic ankle instability. Methods : Twenty-eight adults in their 20s with chronic ankle instability were recruited. After screening test, they were randomized through R studio program as an experimental group (n=14) to apply an ankle strengthening exercise combined with sling-assisted gluteus medius strengthening and a control group (n=14) to apply ankle strengthening exercise. The intervention lasted two times a week for 6 weeks. To compare the intervention effects, the Cumberland ankle instability tool (CAIT) score, static and dynamic balance ability, and muscle strength of lower extremities were measured. Results : The experimental group showed a significant increase in pre and post-intervention Cumberland ankle instability tool (CAIT) score, static and dynamic balance ability, and muscle strengt (p<.05). The control group showed a significant increase in pre and post-intervention CAIT score, dynamic balance ability, and muscle strength (p<.05). The experimental group showed a significant increase in CAIT score, dynamic balance ability, and muscle strength compared to the control group (p<.05), and showed a high effect size. Conclusions : The results of this study confirmed that ankle strengthening exercise combined with sling-assisted gluteus medius strengthening on people with chronic ankle instability the possibility that it could be effective in improving ankle instability and improving dynamic balance ability, and strength by movement. Although additional research is needed to increase the number of participants due to the small sample size, it is hoped that this study will be an optimistic clinical protocol for people with chronic ankle instability.