• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.2
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• pp.19-27
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• 2020

Background: The purpose of this study was to examine the effects of a multi-modal exercise program for patients with chronic low back with respect to pain intensity, trunk muscle strength and Oswestry disability index. Methods: Thirty patients with chronic low back pain were recruited and divided equally into two groups. The multi-modal training program comprised a series of exercises such as warm-up, stabilization exercises, stretching, endurance exercises, and cool down whereas the control group performed only stabilization exercises. The both group spent an equal amount of time performing 60 minutes per day, three times per week, for five weeks. Results: The experimental group demonstrated statistically significant improvements in range of motion, trunk muscle strength, the visual analogue scale, and the Oswestry Disability Index (p<.05). Intergroup comparison showed a statistically significant difference in the range of motion of the lumbar spine and the degree of disability in the experimental group. Muscle strength and pain were statistically significant in both groups. Conclusion: The multi-modal exercise program is effective for patients with chronic low back pain, as it reduces lower back pain, increases trunk muscles strength, and decrease the potential for becoming disabled.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.2
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• pp.23-39
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• 2001

Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. 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, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

• Journal of the Korean Society for Precision Engineering
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• v.30 no.3
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• pp.331-339
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• 2013

The Interest in disease prevention and rehabilitation is increasing depending on increase of patients with spinal. This is being developed using the spine stabilization device is being studied. So far studies have only evaluated the effect on trunk stabilization exercises but analysis of human movement patterns for active movement and passive movement did not. We assessed the muscle activity of trunk and leg muscle during passive and active tilt mode on eight tilt directions at tilt angle of $30^{\circ}$ using 3-D dynamic postural balance training system. We performed experimental study on the muscular activities of trunk muscle about rectus abdominis, external obliques, latissimus dorsi, erector spinae, and leg muscle about rectus femoris, Biceps femoris, Tibialis Anterior, gastrocnemius. As a result, muscle activation was different depending on the direction of movement and pattern. The results indicate that various patterns of spinal stabilization exercise system could be applied to an effective training of chronic low back pain patients.

• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.415-425
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• 2000

It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.

• Journal of Korean Physical Therapy Science
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• v.13 no.1
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• pp.29-38
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• 2006

The purpose of this study lies in finding out the effect that variation of pain and body deflection posture has an influence on the static spinal stabilization after having performed spinal stabilization exercise making degenerative disc disease patients an object over 8 weeks using $CENTAUR^{(R)}$, 3-D spinal stabilization training implement. Subjects : 61 of DDD patients were made as an object of this study (mean age: 45.46 years, SD: ${\pm}12.78$, range: 16-68), their average height was 161.87cm, average weight 60.70kg, 12 males and 49 females were involved. Methods: 8 various investigations were performed and varied values were compared with reinvestigation done after having exercised 8 weeks using 3-D $CENTAUR^{(R)}$. We used VAS(Visual Analog Scale) in order to see the variation of pain intensity, MOS(Modified Oswestry Scale) in order to see activities of daily life. Results VAS was lessened from 7.50 to 2.71, limitation of routine life(MOS) from 20.26 to 9.32, there were remarkable differences statistically(p<0.05). As a result of muscular investigation for static spinal stabilization by 8 variations of body deflection, muscular strength were all increased and there were remarkable differences statistically(p<0.05). Conclusions : It has been turned out that pain and limitation of daily life was lessened as a result of making 61 of degenerative disc disease patients exercised 8 weeks using $CENTAUR^{(R)}$, 3-D spinal stabilization training implement, deep muscular power was increased. Thus it has been turned out that 3-D lumbar stabilization exercise has an effect on the spinal muscles strengthening and alleviation of their pain for degenerative disc disease.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.71-81
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• 2024

Purpose : In this study, we compared the effects of ankle, McKenzie, and cervical stabilization exercises in individuals with a forward head posture. Outcome measures investigated included the neck disability index, craniovertebral angle (CVA), cranial rotation angle (CRA), and thickness of the longus colli muscle (LC) and carotid artery (CA) post-intervention. Methods : The study included 20 individuals with a forward head posture, who were assigned to an experimental group (EG, individuals performed ankle exercises) or control group (CG, individuals performed McKenzie and cervical stabilization exercises). The EG intervention was specifically designed to enhance proprioception in the ankle joint and strengthen the ankle muscles to improve overall stability and function. In contrast, CG interventions aimed to improve neck muscle balance and cervical spine alignment. Paired t-tests were used to analyze intragroup changes and independent t-tests to determine intergroup differences pre-and post-intervention. The significance level for all statistical tests was set at α=.05. Results : We observed significant post-intervention improvements in both groups, specifically, in the CVA, CRA, and LC and CA thickness (p<.05). These results indicate that ankle, McKenzie, and cervical stabilization exercises were useful for neck posture correction, improved muscle balance, and enhanced blood flow to the neck. Conclusion : This study underscores the positive effects of ankle, McKenzie, and cervical stabilization exercises in individuals with a forward head posture. Our study highlights the benefits of these exercises for posture correction and overall neck health and the clinical effectiveness and usefulness of ankle exercises as an important intervention to improve forward head posture.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.9 no.1
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• pp.45-51
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• 2015

This study was to verify effect on muscle strength of trunk and body composition for elderly according to spinal stability exercise with three dimension. We recruited forty elderly participants(twenties as training group, the other twenties as control group) over sixty five aged. The participant performed muscle strength estimation to exercise of eight direction using spinal stability training system. Also, we estimated body composition in participants using inbody 720. Trining group performed direction exercise(F, FOR, R, BOR, B, BOL, L, FOL) and multiple exercise with band exercise, strengthening gym and walking during thirty minute. But control group only performed multiple exercise without direction exercise. All training progressed three days a week for eight weeks. The results showed that muscle strength of trunk in training group increased significantly from 79.9 point to 85.6 point with reducement of body weight, body fat and BMI. However, control group showed a few exercise effect with increasement of amount of muscles and reducement of body fat without muscle strength of trunk. These results means that spinal stability exercise could be helped to prevent obey and fall of elderly caused by muscle strengthening and improving body composition. This could be applied to develop rehabilitation program efficiently based these data.

• Physical Therapy Korea
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• v.11 no.4
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• pp.19-29
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• 2004

Many muscles of the trunk and hip are capable of contributing to the stabilization and protection of the lumbar spine. To have optimal effectiveness, a training program should include dynamic back/stomach/hip exercises. This study was designed to assess the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscle activities during various low back stabilization exercises. Participants were 26 healthy adults (13 males, 13 Females), aged 21 to 28 years. The surface electromyography (EMG) was recorded from the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken during 3 low back stabilization exercises. One-way analysis of variance with repeated measures was used to examine the difference, and a post hoc test was performed with least significant difference. A level of significance was set at p<.05. The significance of difference between men and women, and between the electromyographic recording sites was evaluated by an independent t-test. The EMG activity for the externus oblique and gluteus maximus muscles had significant differences among 3 exercises (p<.05). In males, the EMG activity for the external abdominal oblique muscle had significantly increased differences during exercises 1 and exercise 2 (p<.05). The gluteus maximus muscle had significantly increased differences during exercise 2 and exercise 3 (p<.05). In females, the multifidus muscle had significantly increased difference during exercise 3 (p<.05), the external abdominal oblique muscle had significantly increased difference during exercise 1 (p<.05). and the gluteus maximus muscle had significantly decreased difference during exercise 3 (p<.05). The results were that the external abdominal oblique muscle was apparently activated during the curl-up exercise in females and males, and the multifidus muscle was apparently activated during the bridging exercise in females and during the sling exercise in males and females.1)In comparison of the %MVC between males and females, exercise 2 and exercise 3 apparently activated of the multifidus and gluteus maximus muscles in both males and females (p<.05). The EMG activity of the gluteus maximus muscle of the males significantly increased during exercise 2 and exercise 3 (p<.05). The EMG activity the multifidus muscle of the females was significantly increased during exercise 2 and exercise 3 (p<.05). More research is needed to understand the nature of motor control problems in the deep muscles in patients with low back pain.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.393-397
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• 2012

Purpose: We investigated to identify the effect of robo-horseback riding exercise (RHRE) on trunk muscle activity ratios for patients with low back pain. Methods: Twelve patients with low back pain and twelve healthy adults were recruited for this study. Subjects performed the RHRE with the neutral spine position. The amplitude of electromyography activity was recorded from the selected trunk muscles (internal oblique [IO], rectus abdominis [RA], multifidus [MF], the thoracic part of the iliocostalis lumborum [ICLT]). The ratios of the relative local muscle activity to the global muscle activity in abdominal and lumbar parts were calculated. Results: There were significant differences in the change values of the IO/RA and the MF/ICLT between low back pain (LBP) patients and healthy adults. The IO/RA ratio and the MF/ICLT ratio showed significant increase in LBP patients after training. Conclusion: The RHRE improved the trunk muscle activity ratio in patients with low back pain. The information presented here is important for investigators who use lumbar stabilization exercises as a rehabilitation exercise.

• PNF and Movement
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• v.12 no.4
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• pp.243-248
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• 2014

Purpose: The transverse abdominis and themultifidus muscle are located in the core. They surround one's trunk and help in body stabilization. Specifically, they control spine articulation to maintain posture and balance. Therefore, weakened deep muscle in the trunk may cause spinal malalignment. This study aims to compare the correlation between the thickness of the transverse abdominis and the multifidus muscle and the spine alignment among college students in their 20s. Methods: This study measured the thickness of the transverse abdominis and the multifidus muscle of 42 healthy college students in their 20s using ultrasonic waves. The thickness of the muscle was measured for the length of the cross-section except for fascia. The thickness of the left and right muscles was measured, and the mean value was calculated. As the thickness of the transverse abdominis can increase because of pressure during exhalation, it was measured at the last moment of exhalation. Spinal alignment was measured by the kyphosis angle, lordosis angle, pelvic tilt, trunk inclination, lateral deviation, trunk imbalance, and surface rotation using Formetric III, which is a three-dimensional imaging equipment. They were measured for three times, and the mean values were calculated. The general characteristics of the subjects were analyzed using descriptive statistics. The correlations between each factor were analyzed using Pearson's correlation analysis. Results: The transverse abdominis showed asignificant correlation with trunk inclination (p<.05). The multifidus muscle showed a significant positive correlation with pelvic tilt and a negative correlation with surface rotation (p<.05). Conclusion: The thickness of transverse abdominis and the multifidus muscle appears to influence spinal alignment. Specifically, the multifidus muscle, which plays an important role on the sagittal plane, influences surface rotation, thus making it an important muscle for scoliosis patients. Therefore, a strengthening training program for the transverse abdominis and the multifidus muscle is necessary according to specific purposes among adults with spinal malalignment.