• Physical Therapy Korea
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• v.9 no.3
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• pp.23-37
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• 2002

This study examined the muscle recruitment order during extension of the hip joint in normal subjects, and evaluated whether the external support obtained from wearing a lumbosacral corset had an effect on muscle recruitment leading to increased lumbar stability. The subjects were 40 normal adults (32 male, 8 female) with no history of low back pain and no pathological findings in the nervous or musculoskeletal systems. All subjects extended their hip joints under 3 positions (prone, sidelying, standing). During extension, the onsets of contraction of the rectus abdominis, gluteus maximus, and semitendinosus muscles were measured. Electromyographic activity was measured using a surface electrode, and the muscle contraction onset time was designated as the point exceeding a threshold of 25 ms, using a mean plus twice of the standard deviation. To compare the average order of muscle contraction onset time, a Freedman two-way analysis of variance by ranks was used. The relative difference between muscle contraction onset time wearing and not wearing a lumbosacral corset was measured using a paired t-test. A difference in the average muscle contraction onset order for the rectus abdominis, gluteus maximus, and semitendinosus muscles was observed (p<.05) among three positions. However, wearing a lumbosacral corset did not. change the contraction order. In addition, wearing a lumbosacral corset produced a significant difference (p<.05) in the relative onset time between the rectus abdominis and gluteus maximus in the standing position, but no difference was observed for the other muscles or positions. In the future, patients suffering from low back pain should be compared with normal subjects to determine the effectiveness of a lumbosacral corset in changing muscle recruitment order.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.370-375
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• 2022

Objective: The purpose of this study was to compare the hip joint muscle strength of patients with chronic back pain with lumbar instability and normal subjects. Design: A case control study. Methods: Five types of lumbar instability test were conducted on forty young women with chronic low back pain for more than six months, and those who had 3 or more positive tests were selected as subjects. To select chronic back pain patients with lumbar instability group, aberrant movement patterns during lumbar flexion test (FMT), prone instability test (PIT), posterior-anterior mobility test (PAT), passive lumbar extension test (PLE), and pressure bio-feedback (PBF) were applied. In addition, a digital muscle strength meter was used to measure the hip flexor, extensor, adductor, and abductor muscles of chronic low back pain patients with lumbar instability group (n=20) and normal subject group (n=20). Results: As a result of comparing the hip joint muscle strength between the chronic back pain patient group with lumbar instability and the normal group, there were significant differences in the hip extensor, abductor, and adductor muscles (p<0.05). Conclusions: Patients of chronic back pain with lumbar instability were found to have weak hip joint muscle strength. Therefore, this study suggest that include hip joint strength exercise for functional recovery of chronic back pain patients.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.225-234
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• 2021

Objective: We aimed to identify the effects of proprioceptive neuromuscular facilitation (PNF) stretching on pain, hip range of motion, and functional disability in patients with chronic low back pain. Design: Randomized controlled trial Methods: In total, 45 patients with chronic low back pain were randomly divided into a conventional stretching group (n=22) and a PNF stretching group (n=23). Both interventions were performed three times per week for 6 weeks. Assessments were made using the visual analog scale, Flexion-Abduction-External Rotation test, modified Thomas test, prone hip extension test, and Oswestry disability index before and after the 6-week intervention period. We conducted a paired t-test to compare the within-group findings before and after the intervention. An independent t-test was used to compare the between-group differences. The statistical significance level was set at α=0.05, for all variables. Results: Both groups showed significant improvements in pain, hip range of motion, and functional disability after the intervention (p<0.05). A significant difference was observed in pain, hip range of motion, and functional disability in patients belonging to the PNF stretching group (p<0.05). Conclusions: This study provides evidence that the application of PNF stretching can effectively reduce pain and improve hip range of motion and functional disability in patients with chronic low back pain.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.1
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• pp.19-26
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• 2019

Purpose : The aim of this study was to investigate the effects of the abdominal draw-in (ADI) exercise on the onset times of the gluteus maximus (GM) and erector spinae (ES) as well as the pelvic anterior tilt angle during prone hip extension (PHE). Methods : A total of 24 female adults were divided into two groups: those with normal abdominal muscles (n=12) and those with weak abdominal muscles (WAM; n=12). Before the intervention, the onset times of the GM and ES along with the pelvic angle during PHE were measured. Subsequently, the participants conducted the ADI exercise for 10 minutes. After conducting the ADI exercise, the onset times and the pelvic angle were re-measured. Results : In the pre-intervention comparison between the two groups, the WAM group showed faster ES onset times and higher pelvic angle than the normal group (p<0.05). In the WAM group, the ES onset times were significantly delayed after the ADI exercise (p<0.05). In both groups, the pelvic angle was significantly decreased after the ADI exercise (p<0.05). The decrease in the pelvic angle was significantly greater in the WAM group than in the normal group (p<0.05). The GM onset time was found to be not significant in all comparisons (p>0.05). Conclusion : Therefore, it can be concluded that after performing the ADI exercise, the pelvic anterior tilt during PHE is decreased in normal women and those with WAM, especially in the WAM group, suggesting that the ADI exercise can reduce the compensatory pelvic anterior tilt more effectively by delaying the ES onset times.

• PNF and Movement
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• v.21 no.3
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• pp.309-317
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• 2023

Purpose: This study set out to investigate the effects of prone hip extension with knee flexion (PHEKF) exercises according to external load on the thickness of the gluteus maximus (Gmax) and biceps femoris (BF). Methods: Twenty-three healthy men participated in this study. All subjects randomly practiced PHEKF under the burden of external loads created by sandbags (0 kg, 1 kg, and 2 kg). Rehabilitative ultrasound imaging (RUSI) was used to measure the thickness of the Gmax and BF during the PHEKF with different external loads. Results: The thickness of the Gmax was highest during the 2 kg resistance exercise and lowest at 0 kg. The thickness of the Gmax was significantly increased at 1 kg and 2 kg compared to 0 kg and significantly increased at from 1 kg to 2 kg (p < 0.05). The thickness of the biceps femoris was highest at 0 kg and lowest at 2 kg. The thickness of the biceps femoris muscle was significantly reduced at 1 kg and 2 kg compared to 0 kg (p < 0.05), but there was no significant difference between 1 kg and 2 kg (p > 0.05). Conclusion: The thickness of the Gmax was increased by applying PHEKF with a higher external load, whereas the muscle thickness of the biceps femoris decreased. These results suggest that the application of external loads during PHEKF exercises may be an effective method for selective strengthening of the Gmax.

• Physical Therapy Korea
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• v.29 no.1
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• pp.11-18
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• 2022

Background: Muscle activities of gluteus maximus (GM) and hamstring (HAM) have important roles in the stability and mobility of the hip joint during various functional activities including bridge and prone hip extension exercises. Objects: The purpose of this study is to investigate muscle activities of GM, multifidus (MF) and HAM during three different bridge exercises in healthy individuals. Methods: Twenty healthy subjects were participated. Electromyography device was used to measure muscle activities of GM, MF and HAM. Each subject was asked to perform three different bridge exercises with hip abduction (0°, 15°, 30°) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Statistical significance was set at α = 0.01. Results: The muscle activity of GM was significantly different among three conditions (hip abduction 0°, 15°, 30°) (adjusted p-value [Padj] < 0.01). The muscle activity of GM was significantly greater during bridge exercise with hip abduction 30° compared to 0° and 15° (Padj < 0.01). There was no significant difference in the muscle activity of MF and HAM muscle (Padj > 0.01). The ratio of muscle activity (ratio = GM/HAM) during bridge exercise with hip abduction 30° was significant greater compared to the hip abduction angles 0° and 15° (Padj < 0.01). Conclusion: Bridge exercise with hip abduction 30° can be recommended to selectively facilitate the muscle activity of GM and improve the ratio of muscle activity between GM and HAM.

• Physical Therapy Korea
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• v.26 no.2
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• pp.8-15
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• 2019

Background: Improvement of the lumbo-pelvic stability can reduce the compensatory action of the erector spinae (ES) during prone hip extension (PHE). Furthermore, the application of abdominal drawing-in (ADI) maneuver increases the action of gluteus maximus (GM) and decreases the action of ES during PHE by improving the lumbo-pelvic stability. However, the post-ADI exercise effects on PHE, not the real-time application of ADI maneuver, has not been studied. Objects: This study is aimed at investigating the post-ADI exercise effects on the muscle activities of GM and ES during PHE. Methods: A total of 24 female adults participated in the study, and they were divided into two groups: Those with normal abdominal muscles ($n_1=12$) and those with weak abdominal muscles (WA) ($n_2=12$). Before the intervention, the subjects' GM and ES muscle activities during PHE were measured. Subsequently, the two groups were asked to perform the ADI exercise for 10 minutes. After the ADI exercise, the GM and ES activities were equally measured during PHE. Results: The comparison result of the ES muscle activities before intervention shows a significant difference between the two groups (p<.05); the WA group showed higher muscle activities than the normal group. For the within-group comparison, the muscle activities of the ES in the WA group significantly decreased after the ADI exercise (p<.05). For the GM muscle activity, no significant difference was observed in all comparisons (p>.05). For the changes in muscle activities before and after the ADI exercise, a significant difference exists between the two groups only for the changes in ES activities (p<.05); WA group exhibits higher changes than the normal group. By contrast, no significant difference exists between the two groups for the changes in GM activities (p>.05). Conclusion: After the ADI exercise, the compensatory action of ES in the female adults with WC is implied to decrease during PHE.

• Physical Therapy Korea
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• v.21 no.2
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• pp.8-17
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• 2014

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group ($n_1=14$) and the general neurodevelopment therapy (NDT) group ($n_2=16$). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

• The Journal of Korean Academy of Sensory Integration
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• v.6 no.1
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• pp.35-46
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• 2008

Objective : This study verifies the effects of sensory integrative (SI) therapy on vestibular- and proprioceptive sensory (BPS) processing ability of a child with Asperger Syndrome (AS). Method : A boy who is 11 years and 2 months old took the Functional Independence Measure for Children (Wee-FIM), Canadian Occupational Performance Measure (COPM), Short Sensory Profile, Bruininks-Oserestky Test of Motor Proficiency-2 (BOT-2), and Test of Playfulness (ToP) for the baseline. The child participated in 3 evaluation sessions and 8 therapy sessions based on the AB research design. Duration of each session is 50 min and the therapy session is divided into 40 minutes for treatment and 10 minutes for evaluation. Since the vestibular sense and proprioception build up one's ability of postural control, several tests were employed to evaluate the child' postural control as outcome measure; distance from front leg of chair to heel of the child with sitting (C-H distance), angle between trunk and thigh (hip joint angle) with sitting, and the 'prone-extension posture' which is a subtest of Clinical Observation of Motor and Postural Skill (COMPS) to examine postural control embodied with integration of reflex and BPS processing. Result : During the therapy, average data of the C-H distance is decreased from 27.33cm to 11.69cm, average data of the hip joint angle is also decreased from $43.3^{\circ}$ to $20^{\circ}$, and average time for the prone-extension posture is increased from 13.15seconds to 24.84seconds. Conclusion : This result indicates that the ability to postural control in sitting and to maintain the prone-extension posture can be improved by sensory integrative therapy, with enhanced BPS processing.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.63-68
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• 2009

Purpose : The purpose of this study was to investigate the effect of tensor fasciae latae length on the rotation of pelvis during one leg stance. Methods : 41 healthy adults participated in this study. The movement of the pelvis and trunk was measured using 3-dimensional motion analyzer, during one leg stance. The movement of the pelvis and trunk was collected lateral shift, rotation, side bending, and flexion-extension. Tensor fasciae latae length of subjects was measured in sidelying positon with neutral position of hip joint and flexion $90^{\circ}$ of knee. Also, the range of motion of hip exteral and interal rotaion were measured in prone position wih lexion $90^{\circ}$ of knee. The subjects were separated 2 groups that more pelvic rotation group(n=15) and less pelvic rotation group(n=15) according to the degree of pelvic rotation. Results : The more pelvic rotation group was showed significantly higher in the ROM of hip external rotation than less pelvic rotation group(p<0.05). The difference of tensor fasciae latae length not showed significant difference between groups. During one leg stance, The movement of the shifting and flexion-extension of trunk and pelvis were not showed significant difference. But the side bending and the rotation of pelvis and trunk showed significant difference between groups. Conclusion : The difference of tensor fasciae latae length not showed significantly in more pelvic rotation group and less pelvic rotation group. But, this study suggests that the pelvis instability brings the instability of the trunk during one leg stance.