• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.13-20
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• 2019

PURPOSE: Sitting with crossed legs may have an effect on maintaining a healthy body posture and proper functioning of the respiratory system. Thus, this study's objective was to identify whether or not sitting with crossed legs affects the vertebral angle, chest wall mobility, the pulmonary function, and the activity of the respiratory muscles. METHODS: Thirty healthy subjects were recruited for this study (16 males and 14 females). The vertebral angle, chest wall mobility, pulmonary function, and the activity of the respiratory muscle were measured while the subjects sat in the correct posture and these factors were again measured with the subjects seated with their legs crossed. Three-dimensional motion analysis was used to determine the trunk and lumbar vertebral angles. Surface electromyography was employed to measure the sternocleidomastoid, the rectus abdominis, and the external and internal oblique abdominis muscles. A tapeline was utilized to evaluate the subjects' chest wall mobility. Spirometry was assessed to determine the forced vital capacity and forced expiratory volume in one second. Paired t-tests were then performed (p<.05). RESULTS: There were significant differences in the trunk and lumbar flexion angles, the chest wall mobility, the activity of the right external oblique muscle, and the left internal oblique abdominis muscle. However, the difference in pulmonary function did not reach statistical significance. CONCLUSION: A crossed leg posture caused slight thoracic extension and lumbar flexion, which may lead to a decrease of the chest wall mobility and also to an imbalance of the abdominal muscles. Therefore, sitting with a crossed leg posture should be avoided. Yet a crossed leg posture did not have any clinical effect on the pulmonary function of healthy people. It may be necessary to study the effects of sitting with crossed legs over an extended period of time for patients suffering with impaired respiratory function.

• Physical Therapy Korea
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• v.28 no.3
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• pp.186-193
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• 2021

Background: While the formal test has been used to provide a quantitative measurement of core stability, studies have reported inconsistent results regarding its test-retest and intraobserver reliabilities. Furthermore, the validity of the formal test has never been established. Objects: This study aimed to establish the concurrent validity and test-retest reliability of the formal test. Methods: Twenty-two young adults with and without core instability (23.1 ± 2.0 years) were recruited. Concurrent validity was determined by comparing the muscle thickness changes of the external oblique, internal oblique, and transverse abdominal muscle to changes in core stability pressure during the formal test using ultrasound (US) imaging and pressure biofeedback, respectively. For the test-retest reliability, muscle thickness and pressure changes were repeatedly measured approximately 24 hours apart. Electromyography (EMG) was used to monitor trunk muscle activity during the formal test. Results: The Pearson's correlation analysis showed an excellent correlation between transverse abdominal thickness and pressure biofeedback unit (PBU) pressure as well as internal oblique thickness and PBU pressure, ranging from r = 0.856-0.980, p < 0.05. The test-retest reliability was good, intraclass correlation coefficient (ICC1,2) = 0.876 for the core stability pressure measure and ICC1,2 = 0.939 to 0.989 for the abdominal muscle thickness measure. Conclusion: Our results provide clinical evidence that the formal test is valid and reliable, when concurrently incorporated into EMG and US measurements.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.245-252
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• 2022

Objective: This study aimed to investigate the abdominal muscle activity difference while performing the abdominal bracing technique focusing on inspiration (abdominal bracing group), the general abdominal bracing technique (general bracing group), and the abdominal hollowing technique (abdominal hallowing group) Design: A cross-sectional study design. Methods: Thirty-three healthy participants were recruited for this study. The participants were allocated to 3 different groups; Abdominal bracing group, general bracing group, and abdominal hallowing group. The surface electromyography was placed over the rectus abdominis, external oblique, and internal oblique muscles to collect the activation of abdominal muscles during the trial. Results: The muscle activity of the abdominal bracing group and general bracing groups was significantly higher in all abdominal muscles than in the abdominal hollowing group (p<0.05) Both rectus abdominis and external oblique muscles showed higher muscle activations in the abdominal bracing group over the general bracing group (p<0.05). However, the ratio of bilateral external obliques and rectus abdominis to bilateral internal obliques was highest when the hollowing technique was applied (p<0.05). Conclusions: The results of study showed the abdominal bracing technique that emphasized inhalation rather than the abdominal hollowing technique or general abdominal bracing technique increased the activity of the abdominal muscles. Therefore, this study is considered to be a data for effective training if the abdominal bracing technique that emphasizes inhalation is applied as a method to increase the activation of the abdominal muscles.

• Journal of Korean Physical Therapy Science
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• v.26 no.3
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• pp.23-36
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• 2019

Background: The purpose of this study was to investigate the effect of Plank exercise on unstable support surfaces on flexibility, abdominal muscle thickness and pain in patients with chronic back pain. Design: Randomized controlled trial. Methods: This study was performed on 16 patients with chronic back pain of ◯◯ military unit. Sixteen subjects were randomly assigned into two groups, an upper extremity trainer group (group I, n=8) and a lower extremity trainer group (group II, n=8). The subjects in group I carried out Flank exercise applying the stability trainer to their upper extremities and ones in group II carried out the same exercise applying the stability trainer to their lower extremities for 4 weeks. In order to ascertain the difference between two groups, flexibility, abdominal muscle thickness and pain were measured before and after the exercise. The flexibility was measured by sit and reach test, the thickness of the abdominal muscle was measured by using ultrasonic imaging equipment, and the pain was measured by the visual analogue scale. A paired t-test was utilized to compare changes in pain, abdominal muscle thickness and flexibility before and after flank exercise on unstable support surfaces. Analysis of Covariance (ANCOVA) was performed for ascertaining the significant differences between groups. The significance level was set by α=.05. Results: 1) The flexibilities of two groups were increased after the exercise (p<0.05). 2) In both groups, the thicknesses of rectus abdominis, external oblique abdominis, internal oblique abdominis, and transverse abdominis were all increased after the exercise (p<0.05). 3) The pains in both groups were decreased after the exercise (p<0.05). 4) In the comparisons of two groups, there were no differences in the flexibility, thickness of external oblique abdominis, internal oblique abdominis and transverse abdominis and pain (p>0.05). Whereas only thickness of Rectus abdominis was larger in the group I than in the group II (p<0.05). Conclusion: Plank exercise on the unstable support surface for 4 weeks resulted in increased flexibility, abdominal muscle thickness and pain reduction in patients with chronic back pain. Therefore, it is considered that performing flank exercise on the unstable supporting surface is suitable for the reduction of the pain in patients with chronic back pain. However, in this study, it is considered that continuous and diverse studies are needed because there was not a large difference between the groups when the upper or lower limbs are provided unstable support surfaces.

• Physical Therapy Korea
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• v.18 no.4
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• pp.60-67
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• 2011

Ultrasonography (US) is a recent technique that has proven to be useful for assessing muscle thickness and guiding the rehabilitation decision-making of clinicians and researchers. The purpose of this study was to determine the inter-rater reliability of the US measurement of transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) thicknesses for different probe locations and measurement techniques. Twenty healthy volunteers were recruited in this study. Muscle thicknesses of the transversus TrA, IO, and EO were measured three times in the hook-lying position. The three different probe locations were as follows: 1) Probe location 1 (PL1) was below the rib cage in direct vertical alignment with the anterior superior iliac spine (ASIS). 2) Probe location 2 (PL2) was halfway between the ASIS and the ribcage along the mid-axillary line. 3) Probe location 3 (PL3) was halfway between the iliac crest and the inferior angle of the rib cage, with adjustment to ensure the medial edge of the TrA. The two different techniques of thickness measurement from the captured images were as follows: 1) Muscle thickness was measured in the middle of the muscle belly, which was centered within the captured image (technique A; TA). 2) Muscle thickness was measured along a horizontal reference line located 2 cm apart from the medial edge of the TrA in the captured image (technique B; TB). The intraclass correlation coefficient (ICC [3,k]) was used to calculate the inter-rater reliability of the thickness measurement of TrA, IO and EO using the values from both the first and second examiner. In all three muscles, moderate to excellent reliability was found for all conditions (probe locations and measurement techniques) (ICC=.70~.97). In the PL1-TA condition, inter-rater reliability in the three muscle thicknesses was good to excellent (ICC=.85~.96). The reliability of all measurement conditions was excellent in IO (ICC=.95~.97). Therefore, the findings of this study suggest that TA can be applied to PL1 by clinicians and researchers in order to measure the thickness of abdominal muscles.

• Physical Therapy Korea
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• v.21 no.1
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• pp.63-69
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• 2014

Cross knee curl-up is an ideal variation of abdominal curl up exercise to strengthen abdominal musculature without excessive lumbar flexion which can increase the loads on the disc and ligaments. In addition, slowly forced expiration can facilitate the activation of the abdominal musculature. The purpose of this study was to determine the effects of slowly forced expiration on activity of abdominal muscles, such as rectus abdominis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO), while cross knee curl-up. Eleven young and healthy subjects (6 males and 5 females) participated. All subjects performed the cross knee curl-up slowly forced expiration and natural breathing. Paired t-test was performed in normalized electromyogram (EMG) muscle activity of the bilateral RA, EO, and TrA/IO to compare the differences between the cross curl-up with slowly forced expiration and natural breathing. Statistical significance was set at .05. There were no significant differences in normalized EMG muscle activity of the bilateral RA, EO, and TrA/IO between the cross curl-up with slowly forced expiration and natural breathing. The finding of this study designates that slowly forced expiration does not induce increasing activity of abdominal muscle in cross knee curl-up; hence, learning step of breathing control might not be necessary to strengthen abdominal muscle in cross knee curl-up.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.93-98
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• 2017

PURPOSE: This study investigated the activities of lower limb muscles according to the angle of a medio-lateral ramp while walking to promote awareness of the risks associated with a medio-lateral ramp. METHODS: This study was conducted on 20 healthy male adults. The muscle activities of the vastus medialis oblique (VMO), vastus lateralis oblique (VLO), tibialis anterior (TA) and peroneus longus (PL) were measured while the subjects were walking on a 3 m medio-lateral ramp. Five angles (flat, $2^{\circ}$, $5^{\circ}$, $10^{\circ}$, and $15^{\circ}$) were selected for the angle conditions of the experiment on a medio-lateral ramp. The activities were measured during the stance phase only in the middle cycle of a three-cycle walking experiment. The mean value obtained from the three walking tests was used for the analysis. RESULTS: Results showed that walking on a mediolateral ramp required more muscle activities than walking on a flat surface, through which balanced walking was achieved. CONCLUSION: Walking on a medio-lateral ramp requires proper muscle activation and control, without which the risks of injury to the joints of the lower limbs and falls are likely to increase. Therefore, special attention should be given to older people and the disabled under the condition of traversing a ramp.

• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.201-206
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• 2017

Purpose: The aim of this study was to identify the effects of Pilates mat exercise may improve trunk muscle thickness and balance in healthy adults. Methods: Eighteen healthy adults participated in this study. They were randomly assigned to one of two groups: Pilates mat exercise group (n=9) and the control group (n=9). Subjects in Pilates mat exercise group performed the exercises three days per week for 6 weeks, which consisted of warm up, main workout, and cool down. Trunk muscle thickness of the rectus abdominis (RA), internal oblique (IO), external oblique (EO), transverse abdominis (TrA), multifidus (MF), and erector spine (ES) were measured using an ultrasonography. Balance ability was evaluated using Romberg test and limits of stability (LOS). Measurements were performed before training, 3 weeks after training, and 6 weeks after training. Results: There was a significant difference of RA, EO, IO, MF, and ES according to the main effect of time (p<0.05). There was a significant difference of EO, MF, ES, Romberg, and LOS according to interaction effect between the time and group (p<0.05). There was a significant difference only for LOS according to the main effect of the group (p<0.05). Conclusion: Pilates mat exercise did increase trunk muscle thickness and balance. However, the effect with respect to trunk thickness was limited. Pilates mat exercise appears to be more effective in improving muscles related to trunk extension and balance.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.3
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• pp.25-32
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• 2018

Purpose : This study investigated the effects of different types of plank exercise on abdominal muscle thickness in subjects with asymmetric pelvic anterior tilt. Methods : Participants with a diagnosis of pelvic anterior tilt were divided into an experimental group (n=12) and a control group (n=13). The thicknesses of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were measured using an ultrasound diagnostic apparatus. The data were analyzed using an SPSS (Ver. 21) program. Results : In the experimental group, there was a significant difference in the thicknesses of the left and right muscles in the standing and elbow plank exercises (p<.05). All the muscle thicknesses increased significantly during the plank exercises(elbow plank, right-side plank, and left-side plank) as compared with those in the standing position (p<.05). In addition, the side-plank exercise resulted in significantly higher muscle thickness of the supported side (p<.01, p<.001). Conclusion : These findings suggest that asymmetric exercise should be applied to the change of the left and right muscles of the abdominal when applying plank exercise according to pelvic anterior tilt.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.47-54
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• 2020

Background: This study examined the changes in the leg muscle activities of 30 healthy subjects according to different pressures caused by isometric hip adduction during squat exercise. Methods: With their knee flexed at 60°, the subjects performed isometric hip adduction with a pressure of 0, 20, 40, and 60mmHg. Surface electromyography was used to measure their muscle activities. Changes in the activities of the muscles, such as the gluteus maximus (GMAX), Gluteus medius (GM), vastus medialis oblique (VMO), vastus lateralis oblique (VLO), biceps femoris (BF), and Tensor fasciae latae (TFL) muscles, were analyzed. Results: The activities of the VMO, VLO, GM, BF, and GMAX muscles were significantly different after exercise compared to that before exercise (p<.05). The activities of all the leg muscles measured were highest at a pressure of 60mmHg during isometric hip joint adduction. Conclusion: The pressure produced by isometric hip joint adduction during squat exercise increased the leg muscle activities of the subjects. These results will provide basic data on effective squat exercise to alleviate knee joint diseases.