• Physical Therapy Korea
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• v.23 no.2
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• pp.57-66
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• 2016

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

• Physical Therapy Korea
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• v.14 no.4
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• pp.14-20
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• 2007

To improve abdominal muscles strengthening, double straight leg lowering (DSLL) has been widely used in physical therapy, fitness program, and athletic program. The purpose of this study was to investigate the effects of the lumbar stabilization maneuver with a pressure biofeedback unit on the muscle activity of rectus abdominis (RA), external oblique (EO), and internal oblique (IO) during DSLL. Fourteen healthy young men were recruited from university population. The electromyography (EMG) activity was recorded from the RA, EO, and IO of both sides. The normalized EMG activity was compared using a paired t-test. The study showed that EMG activity in the RA, EO, and IO was significantly higher during DSLL with lumbar stabilization (DSLL-LS) compared to performed DSLL (p<.05). These results suggest that DSLL-LS is recommended as an effective method for strengthening exercise for the abdominal muscles.

• PNF and Movement
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• v.4 no.1
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• pp.1-7
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• 2006

Objective : The purpose of this study was conducted to find scapular movement instability related with shoulder complex and provide strengthening the scapular muscles with proprioceptive neuromuscular facilitation(PNF). Methods : This is a literature study with books and articles, seminar note and book for PNF international course. Results : The scapular serve as the platform for humeral motions. The scapulothoracic articulation is stabilized and controlled, in part, by the scapular muscles. Therefore, if scapular muscle function is altered, then dysfunctional scapulothoracic kinematics may result. Strengthening exercise for scapular muscles are a common part of rehabilitation programs designed for patients with scapular instability. Conclusion : Treatment of the scapular instability is provided. It is that treatment with combination of isotonic, stabilize reversal on different patient's positions.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.112-118
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• 2014

Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

• Physical Therapy Korea
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• v.26 no.3
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• pp.84-90
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• 2019

Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle. Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects. Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF). Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01). Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.41-50
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• 2023

Purpose : The aim of study was to determine the effect of lower trapezius muscle strengthening exercises on the height of rounded shoulder posture and muscle activity in patients with rounded shoulder posture. Methods : Thirty-one subjects with rounded shoulders were selected and assigned, with the use of a random number table, to an experimental group (EG, n=16) that received resistance exercises of the trapezius (lower) muscles or a control group (CG, n=15) that received isometric exercises of the lower trapezius muscles. In the EG, with the subject in a prone position, both arms were abducted at the angles suggested for each posture (145 °, 45 ° abduction), with the hands holding dumbbells to assume a functional posture. The CG performed only isometric exercises without dumbbells in the same conditions. At the start signal, with the thumb raised, the arm was raised to the level of the ear. Both groups were assessed by the height of the rounded shoulder posture (RSP) and muscle activity (EMG). The intervention was performed three times a week. Results : The RSP significantly decreased during the intervention period in both the EG and CG (p<.05), and a significant difference was determined between the RSP of the two groups (p<.05). In the EG, the EMG significantly increased during the intervention period (p<.05), but the CG did not show any significant increase (p>.05). The final EMG was significantly higher in the EG than in the CG (p<.05). Conclusion : Both the EG and CG showed positive improvement in rounded shoulder posture during the intervention period. In particular, lower trapezius resistance exercise appears to reduce shoulder height and positively affects the activity of muscles around the shoulder.

• Journal of Korean Physical Therapy Science
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• v.30 no.3
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• pp.1-13
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• 2023

Background: The bridge exercise prevents repeated damage to the tissues around the spine by reducing stimulus transmission to the ligaments and joint capsules, thereby alleviating back pain. It also contributes to strengthening the muscles of the lower extremities. Design: A Single Subject experience design. Methods: This study was conducted on 28 healthy adults in their 20s to 30s and conducted at St. Mary's Hospital in C City from May to July 2021. Four types of bridge exercise were performed in this study: the normal bridge exercise and bridge exercises with 0.5%, 1%, or 1.5% body weight resistance applied on the pelvis through manual resistance during the bridge exercise and to determine the effect of resistance applied in the bridge exercise on the activation of the trunk and lower extremities muscles. Results:This study showed that the muscle activity of the trunk and lower extremities improved significantly in response to stronger resistance when manual resistance equivalent to 0.5%, 1%, or 1.5% of body weight was applied during the bridge exercise compared to when the normal bridge exercise was performed. Conclusion: This study shows that manual resistance can be applied as an effective method of bridge exercise since muscle activity in the trunk and lower extremities increases when manual resistance causing isometric contraction is applied.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.29-45
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• 2024

PURPOSE: This study aimed to compare the effects of pain level, lower back pain dysfunction level, psychosocial level, hip abductor strength (HAS), number of positive lumbar instability tests, and dynamic balance (DB) by applying lumbar stabilization exercises according to the presence or absence of gluteus medius muscle weakness in chronic lower back pain (CLBP) patients with lumbar instability. METHODS: Thirty-five CLBP patients with lumbar instability were divided into the gluteus medius weakness (n = 18) and gluteus medius non-weakened (n = 17) groups using the gluteus medius manual muscle test. Intervention applied conservative physical therapy and lumbar stabilization exercises to both groups that lasted three times a week for four weeks. To compare the intervention effects, the quadruple visual analog scale (QVAS), the Korean version of the Oswestry disability index (K-ODI), fear-avoidance beliefs questionnaire (FABQ), HAS, lumbar instability tests positive response counter (LIC), and DB were measured. RESULTS: Significant differences were shown for QVAS, K-ODI, FABQ, HAS, LIC, and DB for both groups pre- and post-intervention (p < .05). Compared to the gluteus medius weakness group, the gluteus medius non-weakened group showed a significant difference (p < .05) in the changes in QVAS, K-ODI, FABQ-W, FABQ-total, and HAS. CONCLUSION: In CLBP patients with lumbar instability, having gluteus medius weakness was less effective in improving lumbar stabilization exercise than gluteus medius non-weakness regarding pain level, lower back pain dysfunction level, psychosocial level excluding physical activity, and hip abductor strength. Therefore, additional gluteus medius strengthening exercises are necessary for patients with lumbar instability and gluteus medius muscle weakness.

• Hip & pelvis
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• v.34 no.1
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• pp.10-17
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• 2022

Purpose: This study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture. Materials and Methods: A total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The cross-sectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records. Results: No significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT. Conclusion: Muscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

• Journal of Food Hygiene and Safety
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• v.38 no.2
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• pp.69-78
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• 2023

This study aimed to investigate the protective effect of enzymatically modified stevia (EMS) on C2C12 cell-based model of dexamethasone (DEX)-induced muscle atrophy to provide baseline data for utilizing EMS in functional health products. C2C12 cells with DEX-induced muscle atrophy were treated with EMS (10, 50, and 100 ㎍/mL) for 24 h. C2C12 cells were treated with EMS and DEX to test their effects on cell viability and myotube formation (myotube diameter and fusion index), and analyze the expression of muscle strengthening or degrading protein markers. Schisandra chinensis Extract, a common functional ingredient, was used as a positive control. EMS did not show any cytotoxic effect at all treatment concentrations. Moreover, it exerted protective effects on C2C12 cell-based model of DEX-induced muscle atrophy at all concentrations. In addition, the positive effect of EMS on myotube formation was confirmed based on the measurement and comparison of the fusion index and myotube diameter when compared with myotubes treated with DEX alone. EMS treatment reduced the expression of muscle cell degradation-related proteins Fbx32 and MuRF1, and increased the expression of muscle strengthening and synthesis related proteins SIRT1 and pAkt/Akt. Thus, EMS is a potential ingredient for developing functional health foods and should be further evaluated in preclinical models.