Background: Passive straight leg raising (PSLR) is the common clinical test to measure of hamstring muscle length. Hip flexion angle contributes to change the lumbopelvic rotation during PSLR. Pressure biofeedback unit (PBU) is commonly used to detect lumbopelvic movement during lower limb movements. Thus, there may be the relationship between pressure of PBU and lumbopelvic motion during PSLR. Objects: The objective of this study was to determine the relationship between pressure of PBU and lumbopelvic motion during PSLR. Methods: Thirty two subjects participated in this study. A three-dimensional motion analysis system were used to measure the lumbopelvic angle during PSLR, while recording the pressure of PBU according to angle of PSLR by 10 degree increments. Pearson product moment correlations and linear regression analysis were used to describe the relationship between variables. Results: The results showed that there was a significant relationship between the lumbopelvic and angle of PSLR (Pearson's r=.83, p<.05), between the pressure of PBU and angle of PSLR (Pearson's r=.75, p<.05), and between lumbopelvic motion and pressure of PUB (Pearson's r=.83, p<.05). Linear regression equation using lumbopevic angle as an independent factor was as follows: Pressure of PBU = 47.35 + (2.55 ${\times}$ angle of lumbopelvic motion) ($R^2=.69$, p<.05). Conclusion: Results of the present study indicate that pressure of PBU can be used to indirectly detect the amounts of lumbobevic motion during muscle length test or stretching of hamstring.
Background: The active knee extension (AKE) test commonly used to assess the flexibility of the hamstring muscles. Many researchers have tested the reliability of the AKE test; however, no published studies have examined the intrarater and interrater reliability of the AKE test using a PBU. Objects: The purpose of this study was to determine the intrarater and interrater reliability of the AKE test performed with a pressure biofeedback unit (PBU) on healthy subjects. Methods: Sixteen healthy male participants volunteered and gave informed consent to participate in this study. Two raters conducted AKE tests independently with a PBU. Each knee was measured twice, and the AKE testing was repeated one week after the first round of testing. Results: The interrater reliability's intraclass correlation coefficients ($ICC_{2,1}$) were .887~.986 for the right knees and .915~.988 for the left knees. In addition, the intrarater (test-retest) reliability ($ICC_{3,1}$) values ranged between .820~.915 and .820~.884 for Raters 1 and 2, respectively. The values for the standard error of mesurement were low for all tests ($.81{\sim}2.97^{\circ}$); the calculated minimum detectable change was $2.24{\sim}8.21^{\circ}$. Conclusion: These findings suggest that the AKE test performed with a PBU had excellent interrater and intrarater reliability for assessing hamstring flexibility in healthy young males.
Purpose : Kegel exercises reported that it is effective in managing stress-related or complex urinary incontinence through contraction and relaxation of the pelvic floor muscles. In many previous studies, it was confirmed that Kegel exercise is involved in respiration as well as urinary system diseases. However, there is a lack of research on the effect of pelvic setting when performing Kegel exercises. Therefore, this study was conducted to investigate the effect on maximum voluntary ventilation (MVV) and abdominal muscle thickness through Kegel exercise after lumbar-pelvic motor control using pressure biofeedback unit (PBU). Methods : The subjects of this study were 10 healthy female students in their 20s. Subjects measured MVV with a spirometer. In hooklying, external oblique, internal oblique, and transverse abdominis of the dominant hand were measured using ultrasound. The measured value was an average of three times. After one week of intervention, measurements were made in the same manner. Before Kegel exercise, pelvic setting training was performed using PBU. In hooklying, PBU was placed in the waist and set to 40 mmHg, and it was adjusted to 60 mmHg through pelvic muscle contraction. For Kegel exercise, the pelvis was first set using PBU, and then the pelvic floor muscles were contracted for 8 seconds and relaxed for 8 seconds, 10 times, 1 set, and 3 sets. Results : In MVV, a significant difference was confirmed after exercise than before exercise (p<.05). There was also a significant difference in abdominal muscle thickness before and after exercise (p<.05). Conclusion : Based on the results of this study, Kegel exercise using PBU had an effect on MVV and abdominal muscle thickness. However, since this study was conducted without a control group as a preliminary study, additional research should be conducted to supplement this.
The aims of the current study were to assess reliability of range of motion (ROM) measurement of glenohumeral internal rotation (GIR) with a pressure biofeedback stabilization (PBS) method and to compare the reliability between manual stabilization (MS) and the PBS method. In measurement of pure glenohumeral joint motion, scapular stabilization is necessary. The MS method in GIR ROM measurement was used to restrict scapular motion by pressing the palm of the tester's hand over the subject's clavicle, coracoid process, and humeral head. The PBS method was devised to maintain consistent pressure for scapular stabilization during GIR ROM measurement by using a pressure biofeedback unit. GIR ROM was measured by 2 different stabilization methods in 32 subjects with GIR deficit using a smartphone clinometer application. Repeated measurements were performed in two test sessions by two testers to confirm inter- and intra-rater reliability. After tester A performed measurements in test session 1, tester B's measurements were conducted one hour later on the same day to assess the inter-rater reliability and then tester A performed again measurements in test session 2 for confirming the intra-rater reliability. Intra-class correlation coefficient (ICC) (2,1) was applied to assess the inter-rater reliability and ICC (3,1) was applied to determine the intra-rater reliability of the two methods. In the PBS method, the intra-rater reliability was excellent (ICC=.91) and the inter-rater reliability was good (ICC=.84). The inter-rater and intra-rater reliability of the PBS method was higher than in the MS method. The PBS method could regulate manual scapular stabilization pressure in inter- and intra-rater measuring GIR ROM. Results of the current study recommend that the PBS method can provide reliable measurement data on GIR ROM.
Purpose: The purpose of this study is to investigate differences of cervical flexor muscle thickness (i.e., sternocleidomastoid muscle and deep cervical flexor muscles) depending on levels of pressure bio-feedback unit and eye directions during cranial-cervical flexor exercise in healthy subjects. Methods: A total of 30 subjects (12 males and 18 females) who had no medical history related to musculoskeletal and neurological disorders were enrolled in this study. They were instructed to perform cranial-cervical flexion exercise with adjustment of five different pressures (i.e., 22 mmHg, 24 mmHg, 26 mmHg, 28 mmHg, and 30 mmHg) using a pressure biofeedback unit, according to three different eye directions (i.e., $0^{\circ}$, $20^{\circ}C$, and $40^{\circ}C$). Muscle thickness of sternocleidomastoid muscle and deep cervical flexor muscles was measured according to pressure levels and eye directions using ultrasonography. Results: In results of muscle thickness in sternocleidomastoid muscle and deep cervical flexor muscles, the thickness of those muscles was gradually increased compared to the baseline pressure level (22 mmHg), as levels in the pressure biofeedback unit during cranial-cervical flexion exercise were increasing. In addition, at the same pressure levels, muscle thickness was increased depending on ascending eye direction. Conclusion: Our findings showed that muscle thickness of sternocleidomastoid muscle and deep cervical flexor muscles was generally increased during cranial-cervical flexion exercise, according to increase of eye directions and pressure levels. Therefore, we suggested that lower eye direction could induce more effective muscle activity than the upper eye direction in the same environment during cranial-cervical flexion exercise.
Purpose : This study applied general training (control group) or cranio-cervical flexor training (experimental group) using a pressure biofeedback unit along with general training for 4 weeks to secondary school teachers with moderate to severe neck pain and forward head posture. After that, we tried to compare the effects through differences in neck pain intensity (using numberical rating scale), functional performance (using neck disability index), and cranio-vertebral angle change. Methods : All 50 subjects were randomly assigned to either the "experimental group (n= 25)" or the "control group (n= 25)", and the measurements were evaluated in the same way before the intervention (baseline) and after the intervention (4 weeks). During the intervention period, the subject visited the physiotherapy center and made a reservation three times a week at a fixed time as much as possible, and each training session was thoroughly conducted under the 1:1 guidance of the therapist in charge so that the correct movement and number of times could be performed without compensatory action. Results : As a result of the homogeneity analysis on the general characteristics of the subjects, there were no significant differences between the groups in all variables (p>.05). Compared to the "control group", the "experimental group" showed significant improvement after intervention in all measured variables of neck pain intensity, functional performance, and cranial-vertebral angle (p<.05). Conclusion : For secondary school teachers with forward head accompanied by neck pain, cranio-cervical flexor training using a compression biofeedback unit is an excellent method to show superior pain reduction and functional performance improvement compared to general training alone. In addition, it can be presented as a more effective intervention method that can promote recovery of forward head posture, which is an essential element of the solution.
This study examined the effects of the abdominal drawing-in (ADI) maneuver using a pressure biofeedback on muscle recruitment pattern of erector spinae and hip extensors and anterior pelvic tilt during hip extension in the prone position. Fourteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. The muscle onset time of erector spinae, gluteus maximus, and medial hamstring and angle of anterior pelvic tilt during hip extension in prone position were measured in two conditions: ADI maneuver condition and non-ADI maneuver condition. Muscle onset time was measured using a surface electromyography (EMG). Kinematic data for angle of anterior pelvic tilt were measured using a motion analysis system. The muscle onset time and angle of anterior pelvic tilt were compared using a paired t-test. The study showed that in ADI maneuver during hip extension in prone position, the muscle onset time for the erector spinae was delayed significantly by a mean of 43.20 ms (SD 43.12), and the onset time for the gluteus maximus preceded significantly by a mean of -4.83 ms (SD 14.10) compared to non-ADI maneuver condition (p<.05). The angle of anterior pelvic tilt was significantly lower in the ADI maneuver condition by a mean of 7.03 degrees (SD 2.59) compared to non-ADI maneuver condition (15.01 degrees) (p<.05). The findings of this study indicated that prone hip extension with the ADI maneuver was an effective method to recruit the gluteus maximus earlier than erector spinae and to decrease anterior pelvic tilting.
PURPOSE: This study examined the changes in the thickness of the abdominal muscles, including the transversus abdominis, according to the set pressure applied by a pressure biofeedback unit during contractions of the hip adductor muscles. METHODS: After randomizing 40 healthy adult males in their 20 s and 30 s, the participants were instructed to match the pressure gauge indication of the pressure biofeedback device to continue contracting the hip adductor while maintaining it at 10 mmHg (low), 40 mmHg (medium), or 70 mmHg (high). The measurement was taken over five seconds using an ultrasound device. RESULTS: According to the contractile pressure applied to the hip adductor muscle, there was a significant difference in the muscle thickness change of the transverse abdominis muscle between 10 mmHg and 70 mmHg and between 40 mmHg and 70 mmHg. The muscle thickness ratio of the external oblique/abdominal muscle was significantly different between 10 mmHg and 70 mmHg and between 40 mmHg and 70 mmHg. CONCLUSION: Increased contraction pressure on the hip adductor muscle increases the muscle thickness of the abdominal transverse muscle. Interbody stability exercise with contractions of the hip adductor muscle is expected to help increase in the muscle thickness of the hip adductor muscle.
Purpose : This study was conducted to determine the effect of Kegel exercise using a pressure biofeedback unit (PBU) for 2 weeks on maximum voluntary ventilation (MVV) and abdominal muscle thickness based on previous studies. Methods : The subjects of this study were 20 healthy female students in their 20s. Subjects were randomly assigned to two groups. Eleven subjects were assigned to the experimental group (EG) and 9 subjects were assigned to the control group (CG). Subjects measured MVV with a spirometer. In hooklying position, transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) of the dominant side were measured using ultrasound. For the measurement value, the average value of three times was adopted. After 2 weeks of intervention, the measurements were measured in the same way. In the EG, pelvic setting training using PBU was performed before Kegel exercise. The PBU was first placed at the waist in the Kegel exercise position and the starting pressure was set at 40 mmHg and adjusted to 60 mmHg through pelvic floor muscle contraction. After performing pelvic control using PBU, Kegel exercise was performed with 8 seconds of contraction, 8 seconds of relaxation, and 3 sets of 10 reps per set. A significance level of 𝛼=.05 was used to verify statistical significance. Results : In the variable of MVV, a significant increase was confirmed in the EG (p<.05). In the abdominal muscle thickness variable, significant increases were confirmed in IO and TrA in the EG (p<.05). In addition, a significant increase in IO was confirmed in the CG (p<.05). Significant increases in IO and TrA were confirmed between groups (p<.05). Conclusion : Based on the previous study, this study confirmed that Kegel exercise using a PBU had a positive effect on MVV and abdominal muscle thickness based on a 2-week intervention.
Background: While the formal test has been used to provide a quantitative measurement of core stability, studies have reported inconsistent results regarding its test-retest and intraobserver reliabilities. Furthermore, the validity of the formal test has never been established. Objects: This study aimed to establish the concurrent validity and test-retest reliability of the formal test. Methods: Twenty-two young adults with and without core instability (23.1 ± 2.0 years) were recruited. Concurrent validity was determined by comparing the muscle thickness changes of the external oblique, internal oblique, and transverse abdominal muscle to changes in core stability pressure during the formal test using ultrasound (US) imaging and pressure biofeedback, respectively. For the test-retest reliability, muscle thickness and pressure changes were repeatedly measured approximately 24 hours apart. Electromyography (EMG) was used to monitor trunk muscle activity during the formal test. Results: The Pearson's correlation analysis showed an excellent correlation between transverse abdominal thickness and pressure biofeedback unit (PBU) pressure as well as internal oblique thickness and PBU pressure, ranging from r = 0.856-0.980, p < 0.05. The test-retest reliability was good, intraclass correlation coefficient (ICC1,2) = 0.876 for the core stability pressure measure and ICC1,2 = 0.939 to 0.989 for the abdominal muscle thickness measure. Conclusion: Our results provide clinical evidence that the formal test is valid and reliable, when concurrently incorporated into EMG and US measurements.
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