• Journal of the Korean Society for Precision Engineering
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• v.27 no.2
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• pp.130-136
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• 2010

For stability analysis of the lumbar spine, the hypothesis presented is that the disc has stress sensors driving feedback mechanism, which could react to the imposed loads by adjusting the contraction of the muscles. Fusion in the motion segment of the lumbar spinal column is believed to alter the stability of the spinal column. To identify this effect finite element (FE) models combined with optimization technique was applied and quantify the role of each muscle and reaction forces in the spinal column with respect to the fusion level. The musculoskeletal FE model was consisted with detailed whole lumbar spine, pelvis, sacrum, coccyx and simplified trunk model. Vertebral body and pelvis were modeled as a rigid body and the rib cage was constructed with rigid truss element for the computational efficiency. Spinal fusion model was applied to L3-L4, L4-L5, L5-S1 (single level) and L3-L5 (two levels) segments. Muscle architecture with 46 local muscles was used as acting directions. Minimization of the nucleus pressure deviation and annulus fiber average axial stress deviation was selected for cost function. As a result, spinal fusion produced reaction changes at each motion segment as well as contribution of each muscle. Longissimus thoracis and psoas major muscle showed dramatic changes for the cases of L5-S1 and L3-L5 level fusion. Muscle force change at each muscle also generated relatively high nucleus pressure not only at the adjacent level but at another level, which can explain disc degeneration pattern observed in clinical study.

• Physical Therapy Korea
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• v.13 no.4
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• pp.39-46
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• 2006

The purpose of this study was to determine the effects of slump sitting postures on the masticatory, neck, shoulder, and trunk muscles associated with work-related musculoskeletal disorders (WRMD). Eleven healthy adults (age, $23.3{\pm}2.7$ yrs; height, $174.0{\pm}4.1$ cm; weight, $61.4{\pm}6.6$ kg) participated in this study. The participants were free of injury history and neurologic deficits in the masticatory, neck muscles and upper extremities at the time of participation. The subjects were asked to perform erect and slump sitting postures under the guidance of physical therapists. The surface electromyography (EMG) was recorded from the anterior temporalis, masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique, gluteus maximus muscles of 11 adults as they performed visual terminal display work, which are known as the weakened and tightened muscles owing to WRMD. The recorded signals were averaged and normalized to the mean amplitude of the EMG signal obtained during submaximal reference voluntary contractions. The results of study were as follows: The masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique muscles significantly differed in the slump sitting posture (p<.05). The muscle activities of the serratus anterior, middle trapezius muscle, and external abdominal oblique were significantly lower and that of the masseter, upper trapezius, L3 paraspinal muscles were significantly higher. Further research is needed to assess the motor control problems and the function of the deep muscles in posture stability of patients with WRMD.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.2
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• pp.223-231
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• 2010

Purpose : The Purpose of this study was to compare muscle activation and foot pressure on baby carrier and sling for baby care. Methods : Thirty one women subjects (mean age 23.2 years) participated in four static conditions : unloaded quite standing, carrying an anterior baby carrier, carrying a posterior baby carrier, and sling. The baby carrier and sling were loaded with baby model that filled 7.6kg loads. Surface electromyography was used to measure activity in the internal oblique, T4, L3, L5 paraspinal muscle, vastus medialis, biceps femoris, tibialis anterior, and gastrocnemius for four conditions. And foot pressure was measured by using MatScan system(Tekscan, USA). Results : The activation of Biceps femoris, T4, L3, and L5 paraspinal muscle were significant differences(p<.05), but other muscles were no significant differences in four conditions(p>.05). Right foot contact area and peak pressure of right mid foot area were significant differences in four conditions(p<.05). Conclusion : The results of this study indicate that the use of baby carrier of sling for baby care were influenced postural responses of young women. Further work is recommended to find out the influences of various assistive devices for baby care.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.1-9
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• 2018

PURPOSE: The purpose of this study was to determine the effect of exercise therapy on low back pain (LBP), the function of paraspinal and abdominis muscles, and the sacrohorizontal angle as seen on the radiographs of the lumbar spine in a young female golf player with LBP. METHODS: This case report describes an 11-year-old female golfer who presented with LBP. The exercise therapy program comprised lumbar joint mobilization, lumbar spine flexion distraction, abdominal bridge, plank, side plank, and single-leg extensions from a 4-point kneeling position for 40 min/day; this was done twice a week for 8-weeks. LBP [visual analog scale (VAS) and Oswestry disability index (ODI)] and function of paraspinal and abdominis muscles [Ito test, curl-up test, $90^{\circ}$ stop test, squat test, opened eye one leg stance test (OEOL), and closed eye one leg stance test (CEOL)] were measured before and after 4 and 8 weeks of exercise therapy. The radiographs were analyzed for the lumbar Cobb's angle and sacrohorizontal angle before and after 8 weeks of exercise therapy. RESULTS: After 4 and/or 8 weeks of exercise therapy, VAS and ODI scores decreased; results for the Ito test, curl-up test, $90^{\circ}$ stop test, squat test, and OEOL and CEOL of muscle function improved; and the lumbar Cobb's angle and sacrohorizontal angle improved. CONCLUSION: These results suggest that exercise therapy improves LBP, muscle function, and radiographic parameters associated with LBP in young golf players. These findings have clinical implications for exercise therapy in young female golf players who have LBP.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.88-96
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• 2022

Objective: Purpose of this study was to compare muscle activity ratio of multifidus to erector spinalis according to various cueing including tactile stimulation to provide an effective strategy to provide verbal and tactile feedback during exercise to provoke multifidus muscle activation. Design: Cross-sectional study. Methods: Participants of this study included 28 healthy adults. Muscle activities of the multifidus and erector spinalis were measured while the participants performed tasks according to the three different methods of verbal cueing and three different tactile stimulation. Surface EMG was used to measure the muscular activity of the muscles during all the tasks. Results: Tactile stimulation to abdomen and lumbar vertebrae showed no significant difference in the muscle activity ratio (p>0.05). However, muscle activity ratio of the multifidus in relation to the erector spinalis was increased when subjects were given verbal instructions to make lumbar curvature with little force and to make lumbar curvature while pulling navel (p<0.05). However, it was decreased when they were provided with verbal instruction to make lumbar curvature with strong force (p<0.05). Conclusions: According to the results, proper verbal instruction was an effective tool to increase the muscular activity of multifidus. This study aimed to find and provide the most appropriate verbal cueing while doing exercises to activate multifidus.

• Physical Therapy Rehabilitation Science
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• v.5 no.1
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• pp.40-46
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• 2016

Objective: The purpose of this study was to examine the effect on multifidus and external oblique abdominis muscle activation during hip contraction of three types (concentric, isometric, eccentric) in standing position. Design: Cross-sectional study. Methods: Twenty healthy adult men volunteered to participate in this study. Muscle activation was recorded from gluteus maximus, both multifidus, and both external oblique abdominis by surface electromyography (EMG) while holding position in the type of gluteus maximus contraction. EMG values were normalized by maximum muscle contractions (% maximum voluntary isometric contraction). All subjects performed hip extension with three contraction methods. The type of gluteus maximus contraction using Thera-band was composed of concentric contraction (type 1), isometric contraction (type 2), and eccentric contraction (type 3). To measure muscle activation on the gluteus maximus contraction type, each position were maintained for 5 seconds with data collection taken place during middle three seconds. Muscle activation was measured in each position three times. Results: For the results of this study, there was no significant difference within three contraction patterns of the gluteus maximus (concentric, isometric, and eccentric) each both multifidus, both external oblique abdominis, and gluteus maximus. And there was no significant difference among both multifidus, both external oblique abdominis, and gluteus maximus each hip extension contraction type. Conclusions: These findings suggest that specific contraction types of the gluteus maximus does not lead to a more effective activation of the multifidus, external oblique abdominis, and gluteus maximus.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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• pp.151-163
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• 2009

Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

• Physical Therapy Korea
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• v.30 no.2
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• pp.144-151
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• 2023

Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.135-143
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• 2009

Objectives : Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods : 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results : The amount of fat in the symptomatic side was $7.6{\pm}4.51%$, asymptomatic side was $6.7{\pm}4.29%$. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men $8.5{\pm}5.1%$, women $6.5{\pm}3.6%$). Conclusions : The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.

• Physical Therapy Rehabilitation Science
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• v.7 no.2
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• pp.72-77
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• 2018

Objective: This study aimed to compare the effects of core exercise methods on muscle activation and muscle thickness in healthy young adults and to propose effective core exercise methods. Design: Three-group pretest-posttest design. Methods: A total of 30 healthy young adults (14 males, 16 females) voluntarily participated in the study. Subjects were randomized to the prone plank exercise (n=10), reverse plank exercise (n=10), or bridge exercise (n=10) groups. Muscle activity and thickness of the rectus abdominis (RA), multifidus (MF), external oblique (EO), and internal oblique (IO) muscles were measured using surface electromyography and ultrasound. Subjects from each group participated in the exercises five times a week, with five 20-second sets during week 1. The set time was increased by 10 seconds per week. Results: Muscle activity and thickness in the prone plank, reverse plank, and bridge exercise group were statistically significant different for RA, MF, EO, and IO changes over time, and interaction between time and groups were also significantly different (p<0.05). We analyzed statistically significant differences between groups using a one-way analysis of variance for each period. A significant difference was observed after 4 weeks of exercise (p<0.05). Conclusions: The results suggest that the prone plank exercise is a beneficial method for enhancing muscle activation and thickness of the RA, EO, and IO compared to the reverse plank and bridge exercises. On the other hand, the reverse plank and bridge exercises are effective methods for enhancing the MF compared to the prone plank exercise.