The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.24
no.2
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pp.29-36
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2018
Background: The purpose of this study was to investigate the effect of leg lift difference on serratus and upper trapezius when exercising in a scapula in a prone position, a typical waist stabilization exercise for subjects with a winged scapula. Method: Twenty normal adults and 20 subjects with winged scapula participated in the experiment. The surface EMG recordings were obtained from external oblique muscle and internal oblique muscle during scapula protraction exercise. The presence or absence of winging of the shoulder bone was measured using an electronic digital caliper for the distance the medial border of the scapula is lifted to the rear. In prostrate pier movement posture in both groups, both legs supporting, dominant leg lifting, and non-dominant leg lifting including the scapula protraction were conducted respectively. Results: In the results of comparison between the two groups, the dominant external oblique muscle and the non-dominant internal oblique muscle tended to increase according to the difference of the leg lifting of normal people. In the winged scapula group, internal oblique muscle showed increased muscle activity more than external oblique muscle. Conclusion: It was most effective to exercise with lifting the same position leg for strengthening the same external oblique muscle, and the opposite internal oblique muscle. Also, it is effective to exercise in prone pier movement posture for trunk stability. In addition, internal oblique muscle shows increased muscle activity in subjects with winged scapula. Therefore, appropriate adjustment of external oblique muscle and internal oblique muscle may have a positive effect on scapula dysfunction for trunk stability.
Purpose: This study investigated effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients and was conducted to propose an exercise program for improving cardiovascular function. Methods: Study subjects were 20 patients with hemiplegia due to stroke, who were divided into the deep abdominal muscle strengthening exercise group (experimental group), 10, and the control group, 10. Pulmonary function tests measured FVC and FEV1, dynamic balance ability was measured using TUG. Static and dynamic balance ability was measured using BBS. The experimental group performed exercises during a period of 6 weeks, 5 times a week for 40 minutes, whereas the control group did not participate in regular exercise. The difference before and after the exercise was compared using paired t-test, difference in exercise before and after between groups was ANCOVA and level of significance was set at ${\alpha}=0.05$. Results: The changes in FVC and FEV1 within the group showed a significant difference only in the experimental group (p<0.001) (p<0.01), between-group difference was statistically significant only in FVC and FEV1 changes in the experimental group (p<0.001). The TUG changes within the group showed a significant difference in the experimental group and control group (p<0.001) (p<0.05), while BBS changes showed a significant difference only in the experimental group. Between-group difference was statistically significant only in TUG and BBS changes in the experimental group. The experimental group showed a more effective significant difference than the control group (p<0.001). Conclusion: Can exercise involving a deep abdominal muscle strengthening program be applied in patients with stroke with difficulty in control of trunk and decreased breathing ability?
Journal of the Korean Society of Physical Medicine
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v.13
no.3
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pp.39-47
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2018
PURPOSE: The purpose of this investigation was to conduct a systemic review of studies that examine the effects of strengthening exercise on gait ability and GMFM in children with cerebral palsy and propose a standard for cerebral palsy therapy based on a meta-analysis of the studies. METHODS: An extensive literature search was conducted using databases including the KISS (Korean studies Information Service System), RISS, DBpia, PubMed and ScienceDirect, with the following search terms: 'Strengthening Exercise,' 'Resistance Exercise,' 'Gait ability,' 'GMFM' or 'cerebral palsy'. RESULTS: Eleven studies were included in this review and the duration of the intervention varied from 5 to 24 weeks. The number of application per week was mostly 2-3 times, while 5 intervention per week was adopted in a few cases. The total number of intervention applied varied from 18 to 36 and the respective effect sizes of GMFM on crawling and sitting were very high (1.075 and .881) while those of GMFM on standing and walking were very low(.206 and .125). The effect size was for gait speed was only .221. CONCLUSION: Trunk exercise and lower limb exercise effectively improved GMFM in children with cerebral palsy, resulting in improved outcomes in sitting and crawling. The results of this study will be useful for designing evidencebased cerebral palsy therapy programs.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.11
no.1
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pp.37-48
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2005
Objects: This study is designed to analysis improvement and maintaince of trunk stability targeting patients who need post operative rehabilitation exercise after undergoing opened microscopic laser discectomy(OMLD) due to HNP. Method: Between March 2004 and February 2005 a total sixty patients who underwent OMLD due to $L_4/L_5$, $L_5/S_1$ HNP and who agreed to the experiment were subject for this study. Experimental group consisted of 18 subjects, and they underwent 45 minutes dynamic lumbar stabilization exercise And control group consisted of 18 subjects who conducted conservative physical therapy based on the use of physical modality for 45 minutes except to exercise. Results: Experimental group that was lumbar extensor's isometric peak torque, weight distribution of both leg, trunk muscle balance and Oswestry LBP disability index increased during 12 weeks in a statistically significant manner compared to before exercise (p<.05). When re-test was tried, isometric peak torque (p>.05) and Oswestry LBP disability index(p<.05) maintained 12th week level or improved. Weight distribution rate of both leg and trunk muscle balance maintained the level of 8th week of exercise execution(p<.05). Control group that was lumbar extensor's isometric peak torque, weight distribution rate of both leg and trunk muscle balance aggravated during 12 weeks compared to pre-test(p>.05) But, Oswestry LBP disability index increased in a statistically significant level compared to pre-test(p<.05). When re-test was tried, isometric peak torque increased slightly compared to pre-test, but decreased when at least $60^{\circ}$ flexion angle(p>.05). Weight distribution rate of both leg and trunk muscle balance also aggravated compared to pre-test(p>.05), and Oswestry LBP disability index was similar to the 4th week of physical therapy execution(p>.05). Conclusion: Successive postoperative Especially, Application of dynamic lumbar stabilization exercise program is important than traditional lumbar strengthening exercise program in the maintaince of spinal stability.
The purpose of this study was to assess visual biofeedback's influence on trunk muscles' (EMG) activity and endurance holding time for correct position during whole-body tilt exercise. For the study, we recruited 14 volunteers who showed no symptom of lumbar disease during medical tests. We measured the EMG activity of their rectus abdominis, external abdominal oblique, internal abdominal oblique and erector spinae muscles, and their endurance holding time for correct position during $40^{\circ}$ anterior and posterior whole-body tilt under two conditions: whole-body tilt with and without visual biofeedback. Resistance with gravitational force on the trunk during whole-body tilt was applied by using a device that had a monitor on which the subjects could check their alignment and that sounded an alarm if a subject's alignment collapsed. The study showed an increase in the EMG activity of external abdominal oblique, internal abdominal oblique/rectus abdominis ratio and endurance holding time for correct position during both $40^{\circ}$ anterior and posterior whole-body tilt with visual biofeedback compared with without visual biofeedback (p<.05). We suggest that the whole-body tilt exercise with visual biofeedback could be a beneficial strategy for selectively strengthening the internal abdominal oblique muscle and minimizing the rectus abdominis muscle's activity while maintaining correct alignment during whole-body tilt exercise.
Background: The purpose of this study was to the effects of stretching on lumbar flexibility after lumbar and lower muscle strengthening exercise. Design: Randomized Controlled Trial. Methods: 24 subjects without back pain in their twenties were divided into 12 experimental groups and 12 control groups. The experimental group performed a stretching program after muscle strength exercise. In the control group, only muscle strength exercise was performed, and total exercise was performed 24 times a week for 8 weeks to compare and analyze before and after experiment. Results: The results of this study are as follows: 1) There was no statistically significant difference in both before and after weight of experimental group and control group. 2) There was no statistically significant difference in both before and after skeletal muscle levels of experimental group and control group. 3) There was no statistically significant difference in both before and after fat mass of experimental group and control group. 4) There was a statistically significant difference in both before and after trunk forward flexion of experimental group and control group. Conclusion: This research showed a positive affect on increasing flexibility, which is expected to have a great effect on improvement of flexibility in the future.
Background: The purpose of this study was to investigate the effect of stretching and strengthening exercise on the static flexibility and pain intensity for the iliopsoas muscle, which is one of the main reasons for the chronic low back pain. Methods: The subjects of this study were 15 male adult patients with showed 6 score or higher in the visual analogue scale(VAS) and complained of low back pain over three months who visited department of the physical therapy, KIA motors Industrial Health Center, from October, 2008 through December, 2008. Fifteen subjects were trained stretching, mat exercises and sling exercises for iliopsoas muscle at 4-5 times a week for 4 weeks. I measured the changes on the extensibility of iliopsoas muscle, static flexibility of low back and VAS between pre- and post exercise treatment. Date were analyzed using the Wilcoxon's signed rank test considering the size of the samples. Results: 1. The angle of the hip joint that showed the extensibility of iliopsoas muscle was relieved, which was significant statistically (p<.05). 2. The static flexibility was statistically significantly improved in the trunk flexion test, trunk extension test and Schober-Test (p<.05). 3. The VAS showed decrease, which is significant statistically (p<.05). Conclusion: It is believed that the exercise treatment of iliopsoas muscle has the significant effects on the improvement of static flexibility and decrease of pain intensity for the chronic low back pain patients.
The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.
Journal of the Korean Society of Physical Medicine
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v.8
no.4
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pp.647-653
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2013
PURPOSE: The purpose of this study was to compare the lower extremities muscle activation between squatting exercise with gym ball and wall for improving muscle strengthening in lower extremities. METHODS: Participants were 21 university students (males 10, females 11) who didn't have any problem with orthopedic surgery. Participants performed squatting exercise with gym ball and wall. Squatting exercise with gym ball were performed using by gym ball behind back, and the gym ball were fixed in back and wall. We asked participants to push back the gym ball slightly to prevent fall of ball. Wall squatting exercise, we ask participants to contact their back in wall slightly in order to prevent trunk flexion during performed squatting exercise. Each squatting exercise had performed until knee joint were flexed at 60 degree, and maintained five seconds. We collected data from E.M.G of Biceps femoris, Gastrocnemius, Vastus medialis and lateralis, Tibialis anterior of lower extremity in isometric phase of knee joint angle 60 degree of each squatting exercise. We analysed data using by ANOVA and independent t-test of SPSS PC ver.20.0 in order to compare the muscle activation between squatting exercise with gym ball and wall. RESULT: All of lower extremities muscle activation showed more higher value in squatting exercise with gym ball than squatting exercise with wall, especially there was significantly difference of muscle activation in vastus medialis, tibialis anterior between squatting exercise with gymball and with wall. CONCLUSION: On comprehensively considering the results of the present study, we suggested that squatting exercise with gym ball was more effective method improving lower extremity muscle strengthening.
Purpose: The purpose of this research was to investigate the effects of performing Pilates exercises for eight weeks on the isokinetic trunk strength and balance of female middle school students with lumbago. Methods: Twenty-four female students who met the test requirements were recruited and randomly divided into a control group (CG, n = 16) and a Pilates exercise group (Pilates group; PG, n = 8). The PG performed a Pilates program, which consisted of lumbar muscle strengthening exercises, for 60 minutes three times a week for eight weeks. Data analysis was conducted by two-way repeated ANOVA, and a Bonferroni test was carried out when significant differences appeared. The alpha level was set at 0.05. Results: Following the experimental treatment, the PG showed an increased trunk flexion peak torque of 17% and 13% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased about 31% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Following the experimental treatment, the PG showed an increased trunk extensor peak torque of approximately 29% and 21% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased approximately 27% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Both the CG and the PG showed a 20% and 50% decrease in pain index after the experimental treatment, respectively. After the experimental treatment, the PG had about 50% lower pain than the CG. The average error rate of static balance in the PG reduced by 19% from 3.28±0.45 to 2.65±0.36, confirming a significant improvement. Conclusion: Regular Pilates exercise for eight weeks improved the isokinetic trunk muscle strength of female middle school students with lumbago and relieved their pain. Pilates was also shown to be effective in improving balance.
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