• Physical Therapy Korea
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• v.18 no.1
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• pp.57-63
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• 2011

The purpose of this study was to identify the effects of manual facilitation and a stick on lumbar and hip joint flexion angles in subject with lumbar flexion syndrome during forward bending from a sitting position. Fifteen subjects with lumbar flexion syndrome were recruited for this study. As a pretest, all subjects performed three repetitions of bending the trunk forward until the tips of their fingers touched the target bar. After this pretest, the subjects practiced the forward bending of the trunk 10 times, using either manual facilitation or a stick. Then, as a posttest, all subjects repeated the pretest procedure. The flexion angles of lumbar spine and hip joint during forward bending in a sitting position were measured using a three-dimensional motion analysis system. A paired t-test was used to determine the statistical differences between pre-test and post-test flexion angles and pre- and post-test flexion angle differences between forward bending with manual facilitation and forward bending with a stick. The level of statistical significance was set at p=.05. The results of the study showed that the angle of the lumbar flexion decreased significantly and the bilateral hip flexion angle increased significantly when performing forward bending with stick and manual facilitation. Furthermore, the angle of lumbar flexion decreased significantly and the angle of bilateral hip flexion increased significantly in forward bending with a stick compared to forward bending with manual facilitation. The findings of this study indicate that both forward bending with manual facilitation and sticks could be used to prevent excessive lumbar flexion and increase hip flexion, and that forward bending with a stick is more effective than forward bending with manual facilitation for inducing lumbar spine and hip joint angle changes.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.7 no.1
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• pp.43-48
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• 2009

Purpose : The purpose of this study was to study the effect of rectus abdominal muscle contraction by proprioceptive neuromuscular facilitation trunk stabilization training using extremity simultaneous pattern (PNF trunk stabilization training) and traditional trunk stabilization training methods. Methods : A group of 24 adults male and female, healthy, with no previous medical history nor disability in neuromuscular system and musculoskeletal system was chosen as subjects, and was divided into a control group, a PNF trunk stabilization training group and a traditional trunk stabilization training group. Experiments were performed on the last two groups, 3 times a week for 6 weeks, totaling 18 times. Using a dynamometer, muscle strength and endurance time on trunk flexion were measured before and after each experiment, and surface electromyography in left and right rectus abdominis were measured. Results : following results were obtained; 1. As for the change in the maximal voluntary isometric contraction (MVIC), all subjects in the trunk stabilization training group showed significant difference from those in the control group. 2. As for surface electromyography measurement and the changes in root mean square at the time of trunk flexion, in the left rectus abdominis, PNF trunk stabilization training group showed significant difference from the control group, while in the right rectus abdominis, traditional trunk stabilization training group showed significant difference. Conclusion : To sum up the results, both trunk stabilization training groups showed improvement in the MVIC of abdominal muscle, motor unit action potential activity, but the difference between two trunk stabilization training groups was not significant. Therefore, while trunk stabilization training significantly improved abdominal muscle contraction, but the difference attributable to training methods was found to be insignificant.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.2
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• pp.413-421
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• 2012

Few studies address the use of manual muscle stretching to improve spinal active range of motion(AROM). There is evidence that' Hold-Relax'(HR) is effective for increasing ROM in the extremities, which leads the researchers to anticipate similar benefits in the spine. The purpose of this study is to investigate the effects of HR(trunk flexors) and active thoracic flexion and extension on thoracic mobility, specifically flexion and extension in healthy individuals. A convenience sample of 30 physical therapy students(22-38 years) were randomly assigned to intervention sequence 'A-B' or 'B-A', with at least 7 days between interventions. Intervention' A' consisted of HR of the ventral trunk musculature while 'B' consisted of thoracic flexion-extension AROM. Thoracic flexion and extension AROM were measured before and after each intervention using the double inclinometer method. Paired t-tests were used to compare AROM pre and post-intervention for both groups, and to test for carry-over and learning effects. There was a statistically significant increase(mean=$3^{\circ}$ ; p=0.006) in thoracic extension following HR of the trunk flexors. There were no significant changes in thoracic flexion following HR, or in flexion or extension following the AROM intervention. No carryover or learning effects were identified. HR may be an effective tool for improving AROM in the thoracic spine in pain free individuals. Further investigation is warranted with symptomatic populations and to define the minimal clinical difference(MCD) for thoracic spine mobility.

• Journal of Biomedical Engineering Research
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• v.29 no.6
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• pp.484-492
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• 2008

Sit to stand(STS) movement is one of the most common activity in daily life. In addition, Korean traditionally stand up from various sitting heights in one's daily life compared to other foreigners. As Korea enter rapidly to the aging society, needs of the elderly's independent life are increasing. Therefore the importance of research about the analysis of elderly's activity in daily life is rapidly increasing. In this study, we analyzed joint movements and changes of muscle length during STS(sit-to-stand) at various sitting heights(table seat, bath seat, bottom) in the Korean elderly's daily life by using the motion analysis and musculoskeletal modeling. Ten Korean elderly and young were participated in this experiment. Three heights of sitting posture which could represent typical sitting in Korean daily life were chosen as table seat(42cm), bath seat(21cm) and bottom(0cm). As the results, the elderly showed both smaller knee/hip flexion and larger trunk flexion relatively in comparison to the young during table seat STS. The elderly also showed larger dorsiflexion and smaller ROM of knee, hip, trunk compared to the young during bath seat STS. Additionally, the elderly showed larger plantarflexion, hip flexion, smaller knee flexion and trunk flexion during the first half of bottom STS and larger knee flexion, hip flexion and trunk flexion during the second half of bottom STS. In addition, we could know contraction and relaxation characters of major muscles in lower limb during various STS through the analysis of changes in muscle length by musculoskeltal modeling.

• Physical Therapy Korea
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• v.14 no.1
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• pp.21-27
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• 2007

The purpose of this study was to evaluate isometric trunk extension strength in hemiplegic patients, and to compare that with normal subjects to find a correlation between trunk extension strength and the functional independent degree in hemiplegic patients. Fifteen hemiplegic male patients (mean age $55.2{\pm}10.2$ years) and twenty-five healthy male subjects (mean age $54.6{\pm}10.3$ years) completed isometric trunk extension. Strength was measured at 0, 12, 24, 36, 48, 60, and 72 degrees of trunk flexion. The functional independent degree was assessed by Functional Independence Measure (FIM). Mean isometric trunk extension strength was 91.2 ft-lbs, 120.7 ft-lbs, 142.3 ft-lbs, 156.4 ft-lbs, 173.5 ft-lbs, 184.1 ft-lbs, and 195.3 ft-lbs in the hemiplegic patients group, and 135.6 ft-lbs, 175.6 ft-lbs, 204.4 ft-lbs, 221.9 ft-lbs, 231.2 ft-lbs, 246.8 ft-lbs, and 259.7 ft-lbs in the normal subjects group. The values of isometric trunk extension strength had a descending linear correlation pattern from trunk flexion angle to extension angle. Trunk extension strength in hemiplegic patients was significantly lower than that of normal subjects (p<.05) but did not correlate with the FIM total score (p>.05). Therefore, the isometric trunk extension strength in hemiplegic patients was lower than that of normal subjects and did not correlate with the functional independent degree.

• Journal of the Ergonomics Society of Korea
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• v.30 no.5
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• pp.637-644
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• 2011

Objective & Background: When applying various evaluation tools that analyze work posture risk through observation, accurate measurement of body flexion angle is very important. Method: This study investigated differences and appropriateness of 5 different existing reference points commonly used in the analysis of the work posture. Twenty five ergonomist and trained professionals were participated in this study. A Same flexion angle was utilized for the evaluation of risk assessment of musculoskeletal disorders using five different reference points to investigate the degree of difference between them. To investigate how different the observers' preferred flexion angle measuring methods were compared to the ISO 11226 Reference Posture, a virtual body model was constructed using the Poser 6.0 program. Six types of body flexion postures were constructed, and since neck flexion differs according to body angle, five types of neck flexion postures were constructed with the trunk bending $20^{\circ}$ forward, making up a total of 30 virtual flexion postures. Results: Results showed that the observers used personally preferred reference points instead of reference points recommend in the evaluation tools. Also the results revealed the their seems to be 6 types of flexion angle for the trunk and 11 types of measurement methods for the neck flexion angle in the form of personally preferred reference points. The results showed that a mean difference of $14^{\circ}$($4{\sim}23^{\circ}$) occurred in the trunk, and a mean difference of $20^{\circ}$($-8{\sim}51^{\circ}$) occurred in the neck. To increase accuracy when using the 5 evaluation tools in combination, the ISO 11226 standards, observers' preferred flexion posture standards, and common flexion posture standards of the evaluation tools were compared with the reference points of the 5 evaluation tools. Results showed considerable variance in angle difference for each evaluation tool. Conclusion: According to the results of this study, considering the angle difference between the flexion angle reference points of the evaluation tool and the reference points selected by the observers, it is concluded that instead of personally preferred reference points, the standardized reference points to enhance the accuracy and the objectivity. Application: The result of this study can be used as reference guide to develop the standardized reference point in the future.

• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.110-115
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• 2022

Purpose: The purpose of this study was to examine the effect of sling exercise on pain, trunk strength, and balance in patients with chronic low back pain in their 40s and 50s. Methods: Twenty patients with chronic low back pain were divided into two groups, 10 patients in the exercise group using a sling and 10 patients in the waist stabilization exercise group, applying a random assignment, draw-out method, and sling exercise was applied for 50 minutes a day, 3 times a week, for a total of 5 weeks. For data analysis, a corresponding t-test was performed for within-group changes and an independent t-test was performed for inter-group changes, and the significance level was α=0.05. Results: After 5 weeks, there were significant differences in all items of within-group changes, and the inter-group changes after 5 weeks demonstrated significant differences in pain, trunk flexion strength, and balance. Conclusion: The results of this study showed that exercise using a sling had positive effects on pain, trunk flexion strength, and balance changes in chronic low back pain patients. It is suggested that sling exercise can be used as an intervention method for pain reduction and functional improvement of patients with chronic low back pain in clinical practice.

• Journal of Korean Academy of Nursing
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• v.33 no.1
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• pp.79-86
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• 2003

Purpose: The purpose of this study was to identify the effects of Koryo Hand-Acupuncture on health status(pain, trunk flexion, IADL, depression) of patients with chronic low back pain. Method: This study used a quasi experimental pre-test and post-test design. Data were collected from December 1st, 2000 to December 20th, 2001. 63 chronic low back pain patients(35 experimental group, 28 control group) admitted to the Back-School and consented to this study. The experimental group participated in treatment: Koryo Hand-Acupuncture and AB-Bong. Two groups was homogeneity. After 4 weeks the effects of treatment on the health status was measured between experimental and control group. Data were analyzed using SPSSWIN 10.0 with crosstab, t-test, and paired t-test. Result: In the experimental group, pain(t=4.85, p=.000) and IADL difficulty(t=2.05, p=.045) was significantly lower than those in the control group. It makes no difference trunk flexion(t=-1.60, p=.114) and depression(t=1.50, p=.138) between experimental and control group. Conclusion: These findings indicate that Koryo-Hand Acupuncture is an effective method for reducing pain and IADL difficulty in patients with chronic low back pain, and is considered as a independent nursing intervention for chronic low back pain.

• PNF and Movement
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• v.16 no.3
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• pp.345-353
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• 2018

Purpose: The purpose of the present study was to compare the effects of proprioceptive neuromuscular facilitation (PNF) and static stretching on weight distribution and flexibility for trunk flexion. Method: Sixty participants who had no musculoskeletal disorders were recruited from a local university within six months of this study. The participants were randomly assigned to a PNF stretching group (N=30) and a static stretching group (N=32). For the pre-and post-measurement design, the left-right weight distribution, anterior-posterior weight distribution, and finger-to-floor distance (FFD) were measured before and after the stretching interventions. Result: The FFD results were significantly improved after the interventions, regardless of the group differentiation (p<0.05). The PNF stretching intervention significantly increased the differences between anterior and posterior weight distribution compared to the static stretching group (p<0.05). Conclusions: Both the PNF and static stretching interventions could improve flexibility for trunk flexion mobility. Although the PNF intervention improved the weight distribution in the anterior-posterior direction, further research is required to investigate the various PNF interventions on left-and-right and anterior-posterior weight distribution.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1750-1755
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• 2019

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal $CO_2$ ($EtCO_2$) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at ${\alpha}=.05$. Results: The patients with CLBP had significantly less $EtCO_2$ and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.