• Physical Therapy Korea
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• v.26 no.1
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• pp.51-59
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• 2019

Background: Chronic low back pain (CLBP) causes morphological changes in muscles, reduces muscle strength, endurance and flexibility, negatively affects lumbar stability, and limits functional activity. Plank exercise strengthens core muscles, activates abdominal muscles, and improves intra-abdominal pressure to stabilize the trunk in patients with CLBP. Objects: We investigated the effect of plank exercise on abdominal muscle thickness and disability in patients with CLBP. Methods: We classified 33 subjects into 2 groups: An experimental (n1=17) and a control group (n2=16). Patients in the experimental group participated in plank exercise and those in the control group participated in stretching exercise. Patients in both groups attended 20-minute exercise sessions thrice a week for 4 weeks. Abdominal muscle thickness in each subject was evaluated ultrasonographically, and disabilities were assessed using the Oswestry disability index (ODI). Results: Four weeks later, abdominal muscle thickness showed a significant increase over baseline values in both groups (p<.05). Patients in the experimental group reported a more significant increase in the thickness of the external oblique muscle than that in the control group (p<.05). ODI scores in the experimental group were significantly lower after intervention than before intervention (p<.05). Conclusion: Plank exercise increases the thickness of the external oblique muscle and reduces disability secondary to mild CLBP. Therefore, plank exercise is needed to improve lumbar stability and functional activity in patients with mild CLBP.

• The Journal of Korea CHUNA Manual Medicine
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• v.5 no.1
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• pp.77-84
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• 2004

Objectives : This study was designed to investigate the correlation between thoracolumbar junction and back-su points, Hwatahyeopcheok points for treatment of low back pain in the thoracolumbar junction syndrome that was suggested by Maigne R. Method : We Investigate the acupuncture points that was correlated with the location of thoracolumbar junction area. And We tried to find out a common point between thoracolumbar junction and back-su points, Hwatahyeopcheok points for treatment of low back pain. Results and Conclusion : 1. It is considered that these points such as $BL_{20}$, $BL_{21}$, $BL_{22}$, and Hwatahyeopcheok points that are located from 11th thoraic spinous process to 2nd lumbar spinous process are correspond to the thoracolumbar junction area. 2. It is suggested that acupuncture treatment on $BL_{20}$, $BL_{21}$, $BL_{22}$, and Hwatahyeopcheok points can release the tenderness of the muscles, recover autonomic nervous function and release smooth muscles and vascular contraction, so it can treat low back pain caused by thoracolumbar junction.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.156-160
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• 2021

Objective: Low back pain easily becomes chronic and has a high recurrence rate. Therefore, it is most important to prevent chronicity and reduce the risk of recurrence in the early stages of back pain or at the stage with mild pain. Therefore, this study was conducted to compare hip joint muscle strength, trunk muscle endurance, and pelvic alignment between subjects with mild low back pain and subjects without back pain. Design: Crossed-sectional study Methods: The study was conducted by recruiting 30 students in their twenties who are enrolled in K University in Gyeongsangnam-do, and classifying them into 15 patients with mild back pain and 15 patients with normal. The subjects who participated in the experiment were measured for hip flexor and extensor muscle strength, trunk flexion and extension muscle endurance, and pelvic alignment. To measure hip joint muscle strength, biodex was used, and muscle endurance of the trunk was recorded at the end range of the trunk flexion and extension. And pelvic alignment was measured using Formetric 4D. Results: There were no significant differences in hip joint muscle strength, pelvic alignment, and trunk extension muscle endurance. The retention time was found to be significantly shorter in the mild low back pain group than in the normal group for trunk flexion muscle endurance. Conclusions: In the early stages of back pain or in the mild pain stage, training to increase muscle endurance of the flexor muscles may be helpful.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.216-221
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• 2019

Purpose: This study examined the effect of visual feedback squat on the core muscle thickness of young adults experiencing back pain. Methods: Thirty adult men and women who experienced back pain were assigned randomly to 15 members of the visual feedback squat group (VSG) and 15 of the normal squat group (NSG) to train three times a week for a total of eight weeks. The core muscle thickness was compared prior to the test for four weeks and eight weeks after the test by dividing it into warm-up exercise, main exercise, and 10 minutes finishing exercise. Before, and four weeks and eight weeks later, the thickness of the core muscle was compared using an ultrasonic imaging system. Repeated measured ANOVA was performed to compare the groups, and a Bonferroni test was performed as a post-hoc test to assess the significance of the timing of the measurements in each group according to the periods. An independent t-test was conducted to test the significance between the groups according to the measurement points. Results: A significant change in the main effects of time and interactions of the time difference in muscle thickness of transvers abdominis were observed between the visual feedback squat and control groups according to the measurement point (p<0.05). No significant difference in the muscle thickness of both muscles was observed between the groups with the exception of the right abdominis (p>0.05). Conclusion: These findings suggest that visual feedback squat exercise is expected to have positive effects on the development of transverse abdominis in core muscles.

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.311-327
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• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.2
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• pp.31-38
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• 2009

Objectives : This study is designed to find out the influence of acupuncture treatments on Iliopsoas muscles of disc herniated patients. Method : Control group took usual acupuncture therapies and sample group took acupuncture therapies on their Iliopsoas muscles and usual acupuncture therapies. To Conclude the results, we studied Numerical Rating Scale(NRS) score and changes of SLR-test angle statistically. Results : The improvement rate of the group who took Iliopsoas muscles and usual acupuncture therapies was higher than the group who only took usual acupuncture therapies. Conclusion : In this study, we found out that the treatment on Iliopsoas muscles is effective to low back pain patients.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.59-66
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• 2006

Purpose : The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of lumbar paraspinal muscles of normal healthy people. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Methods : Sixty male college students ranging 19 to 34 years were screened and % maximal voluntary contraction(% MVC) of trunk muscles on the four positions of back extension exercise was compared during the pre and post of inspiration of diaphragmatic breathing. Results : 1. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic right arm and left leg extension position(p<0.05). 2. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic left arm and right leg extension position(p<0.05). 3. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying prone extension position(p<0.05). 4. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying on prone position(p<0.05). Conclusion : This study will be used as the purpose of data collection of lumbar paraspinal muscles on diaphragmatic breathing and be introduced as the new therapeutic intervention for management of patients with back pain.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.22 no.3
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• pp.257-264
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• 2012

Objectives: This study's aims were to evaluate the effects of load center of gravity within an object lifted and feet placements on peak EMG amplitude acting on bilateral low back muscle groups, and to suggest adequate foot strategies with an aim to reducing low back pain incidence while lifting asymmetric load. Methods: The hypotheses that asymmetric load imposes more peak EMG amplitude on low back muscles contralateral to load center of gravity than symmetric load and maximum peak EMG amplitude out of bilateral ones can be relieved by locating one foot close to load center of gravity in front of the other were established based on biomechanics including safety margin model and previous researches. 11 male subjects were required to lift symmetrically a 15.8kg object during 2sec according to each conditions; symmetric load-parallel feet (SP), asymmetric load-parallel feet (AP), asymmetric load-one foot contralateral to load center of gravity in front of the other (AL), and asymmetric load-one foot ipsilateral to load center of gravity in front of the other (AR). Bilateral longissimus, iliocostalis, and multifidus on right and left low back area were selected as target muscles, and asymmetric load had load center of gravity 10cm deviated to the right from the center in the frontal plane. Results: Greater peak EMG amplitude in left muscle group than in right one was observed due to the effect of load center of gravity, and mean peak EMG amplitudes on both sides was not affected by load center of gravity because of EMG balancing effect. However, the difference of peak EMG amplitudes between both sides was significantly affected by it. Maximum peak EMG amplitude out of both sides and the difference of peak EMG amplitude between both sides could be reduced with keeping one foot ipsilateral to load center of gravity in front of the other while lifting asymmetric load. Conclusions: It was likely that asymmetric load lead to the elevated incidence of low back pain in comparison with symmetric load based on maximum peak EMG amplitude occurrence and greater imbalanced peak EMG amplitude between both sides. Changing feet positions according to the location of load center of gravity was suggested as one intervention able to reduce the low back pain incidence.

• Journal of the Ergonomics Society of Korea
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• v.20 no.2
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• pp.71-82
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• 2001

Twisting posture in lifting tasks has been identified as a risk factor of low back pain. However, it has been usually estimated in terms of compressive stress or muscular activity. Thus, this study was conducted to predict the influence on muscular fatigue during lifting simulation. Fifteen young and healthy subjects were recruited and performed isometric trunk exertions during upright standing, two-level flexions and five-level asymmetric twisting conditions. EMG signals from five primary trunk muscles in right part of body were collected during 20sec for 45 different lifting conditions. RMS(root mean square) and MPF(mean power frequency) parameters were used to analyze the EMG signals. Twisting postures were significant in right erector spinae(ERSR), right latissimus dorsi(LATR), right internal oblique(INOR) for muscular activities. Especially, when trunk was $30^{\circ}$ CCW twisting posture. ERSR and INOR activities increased respectively by 11% and 3%. Regarding the trunk muscle fatigue, we found that MPF shifts in twisting posture increased 2.3 and 2.6 times for ERSR and INOR muscles respectively. Therefore, It is probable for workers to suffer from low back disorders when they were exposed to a extreme twisting posture during prolonged lifting. This study suggests NIOSH(National Institute for Occupational Safety and Health) lifting equation needs the time-duration multiplier in addition to asymmetric multiplier.

• Journal of the Ergonomics Society of Korea
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• v.27 no.2
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• pp.1-7
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• 2008

This study quantified 7 trunk muscles' physiological cross-sectional areas (PCSAs) and developed prediction equations for the physiological cross-sectional area as a function of anthropometic variables for Korean people. Nine females and nine males were participated in the magnetic resonance imaging (MRI) scans approximately from S1 through T8. Muscle fiber angle corrected cross-sectional areas (anatomical cross sectional areas: ACSAs) were recorded at each vertebral level and maximum value of ACSAs were determined as physiological cross sectional area (PCSA). There was a significant gender difference in PCSAs of all muscles (p<0.05). Stepwise linear regression techniques using anthropometric measures (e.g., height, weight, trunk depths and widths) as independent variables were conducted to develop prediction equations for the PCSA for each muscle. For males, six muscles' significant prediction equations (p<0.05) were developed except quadratus lumborum. For females, three prediction equations were developed for psoas, quadratus lumborum, and erector spinae muscles (p<0.05).