• Physical Therapy Korea
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• v.25 no.2
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• pp.44-52
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• 2018

Background: The deep cervical flexor (DCF) muscles have a crucial role in the management of neck pain. For preventing neck pain by activation of the DCF, craniocervical flexion (CCF) is an effective exercise. However, sternocleidomastoid (SCM) muscle is considered to affect negatively the activation of the DCF. SCM muscle which is an accessory muscle for respiration is activated differently depending on types of breathing patterns. It's not certain that breathing patterns affect the SCM and DCF muscles thickness during CCF exercise. Objects: The purpose of this study was to investigate the influence of breathing patterns on the SCM and DCF muscles thickness during CCF exercise. Methods: Forty-five subjects participated in this study, and they were classified according to their breathing pattern, as follows: costodiaphragmatic breathing (CDB) and upper costal breathing (UCB) groups. Ultrasonographic imaging of the SCM and DCF muscles was performed during five incremental levels of CCF during tidal breathing and expiration. Results: There was a significant interaction between the breathing pattern and the phase of CCF for percentage of SCM muscle thickness changes (p<.05). In phase 1 CCF, a percentage of SCM muscle thickness changes was increased in the UCB group than in the CDB group (p<.05). There was an increase in DCF muscles thickness with each additional CCF phase (p<.05). Conclusion: Recruitment of SCM muscle was increased in the UCB group while performing CCF with a low intensity. There were no significant differences on DCF recruitment between the breathing pattern groups. Higher CCF exercise intensities elicited a higher DCF recruitment.

• The Journal of Korean Physical Therapy
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• v.15 no.1
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• pp.155-170
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• 2003

Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. There in evidence of muscle dysfunction related to the control of the movement system. There is a clear link between reduced proprioceptive input, altered slow motor unit recruitment and the development of chronic pain states. Dysfunction in the global and local muscle systems in presented to support the development of a system of classification of muscle function and development of dysfunction related to musculoskeletal pain. The global muscles control range of movement and alignment, and evidence of dysfunction is presented in terms of imbalance in recruitment and length between the global stability muscles and the global mobility muscles. The local stability muscles demonstrate evidence of failure of aeequate segmental control in terms of allowing excessive uncontrolled translation or specific loss of cross-sectional area at the site of pathology Motor recruitment deficits present as altered timing and patterns of recruitment. The evidence of local and global dysfunction allows the development of an integrated model of movement dysfunction. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model in proposed and evidence for the efficacy of the approach provided.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6337-6342
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• 2012

Background: Clinical trials on cancer subjects have one of the highest dropout rates. Barriers to recruitment range from patient-related, through institutional-related to staff-related factors. This paper highlights the low response rate and the recruitment barriers faced in our Qigong exercises trial. Materials and Method: The Qigong trial is a three-arm trial with a priori power size of 114 patients for 80% power. The University Malaya Medical Centre database showed a total of 1,933 patients from 2006-2010 and 751 patients met our inclusion criteria. These patients were approached via telephone interview. 131 out of 197 patients attended the trial and the final response rate was 48% (n=95/197). Results: Multiple barriers were identified, and were regrouped as patient-related, clinician-related and/or institutional related. A major consistent barrier was logistic difficulty related to transportation and car parking at the Medical Centre. Conclusions: All clinical trials must pay considerable attention to the recruitment process and it should even be piloted to identify potential barriers and facilitators to reduce attrition rate in trials.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.38-43
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• 2011

Background: In the brain, the dominant primary motor cortex (M1) has a greater hand representation area, shows more profuse horizontal connections, and shows a greater reduction in intracortical inhibition after hand exercise than does the non-dominant M1, suggesting a hemispheric asymmetry in M1 plasticity. Methods: We performed a transcranial magnetic stimulation (TMS) study to investigate the hemispheric asymmetry of paired associative stimulation (PAS)-induced M1 plasticity in 9 right-handed volunteers. Motor evoked potentials (MEPs) were measured in the abductor pollicis brevis (APB) muscles of both hands, and MEP recruitment curves were measured at different stimulation intensities, before and after PAS. Results: MEP recruitment curves were significantly enhanced in the dominant, but not the non-dominant M1. Conclusions: These results demonstrate that the dominant M1 has greater PAS-induced plasticity than does the non-dominant M1. This provides neurophysiological evidence for the asymmetrical performance of motor tasks related to handedness.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.11-22
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• 2004

The concept of segmental stabilization has been one of the most exciting advancements in the field of physical therapy. Specific deep stabilizing muscle have proven to reverse motor control deficits that occurs after back injury. After an injury, a new motor programming strategy is adopted and there is excessive recruitment of the large , strong , global muscular system works instead of small segmental deep muscle recruitment for stability. Many physical therapists and doctors mistakenly prescribe therapeutic exercise for low back pain to use larger, superficial musculature to strengthen the spine for stability and pain control. But motor control coordination of local segmental muscle is actually the key to stability and pain control, not strengthening of global muscle. A recent focus in physiotherapy management of patients with chronic back pain has been the specific training of muscles surrounding the lumbar spine whose primary role is considered to be the provision of dynamic stability and segmental control to the spine. These are the deep transverse abdominis muscle and lumbar multifudus.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.497-504
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• 2011

Purpose : Chronic cervical pain is a common source of disability in society. There has been no research regarding the amount of pressure for the deep cervical flexors during cranio-cervical flexion exercise (CCFE). The purpose of this study is to determine optimal pressure levels to facilitate deep cervical muscles (longus colli & longus capitis) during cranio-cervical flexion exercise, using ultrasound measurement of the muscles. Methods : Using a cross-sectional design, the study was performed in an experimental group of 19 subjects (7 men, 12 women) with no cervical pain. Participants were instructed to perform the CCFE, and during the five incremental stages of the test, changes in thickness, as compared to resting baseline values, were measured using ultrasonography for sternocleidomastoid muscle (SCM) and deep cervical muscles (DCF). Results : Both DCF and SCM muscles demonstrated an increase in recruitment with each progressive phase of the test. In comparing the different pressure increments, the most significant changes found in DCF thickness were between phase 2 and phase 3 (p<.05). However no differences were found between pressure increments for SCM thickness (p>.05). Conclusion : The results suggest 26 mm Hg as the optimal pressure level during cranio-cervical flexion exercise for facilitation of deep cervical flexor.

• Physical Therapy Korea
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• v.20 no.3
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• pp.27-35
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• 2013

The aim of this study was to compare the electromyographic (EMG) activity levels of the scapular upward rotators [upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA)] and other scapular muscles [posterior deltoid (PD), levator scapulae (LS), and infraspinatus (IS)] during isometric lower trapezius exercises. Twenty males with no medical history of shoulder pain or upper extremity disorders were recruited for this study. EMG activity was recorded from the UT, LT, SA, PD, LS, and IS while subjects performed three different exercises: Prone arm lift (PAL), Backward rocking diagonal arm lift (BRDAL), Modified Prone Cobra (MPC). One-way analysis of variance (ANOVA) was used to determine any significant differences among the three exercises. A lower relative activation of UT, LT, and SA was seen with the MPC than with the other exercises (p<.05). The relatively lower activation of the UT identified, the MPC exercise as the preferred choice for preferential strengthening the LT (p<.05). However, a higher activation in the PD, LS, and IS occurred with the MPC than with the other exercises (p>.05). The recruitment pattern of synergist varied depending on the exercise posture. These findings suggest that exercise posture is an important factor in the selection of strengthening exercise for weak muscle.

• PNF and Movement
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• v.22 no.1
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• pp.151-158
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• 2024

Purpose: The present study investigated how variations in diagonal exercises affect shoulder muscle activity, examining changes in neuromuscular activation during scapular and shoulder diagonal patterns of exercises. Furthermore, we explored whether the exercise phase affects muscle activation. Methods: Sixteen asymptomatic male participants were recruited. Four diagonal pattern exercises (scapular anterior elevation, posterior elevation, flexion-adduction-external rotation, flexion, abduction-external rotation), and two exercise phases (concentric and eccentric) were administered. Surface electromyography data were collected. Results: Upper trapezius activity was significantly higher during the concentric phase of scapular posterior elevation exercises compared with the others (p<0.05). The serratus anterior, anterior deltoid, and infraspinatus activities were significantly higher during shoulder diagonal pattern exercises compared with the scapular diagonal pattern exercises (p<0.05). Except for the lower trapezius, muscular activities during the concentric phase were significantly greater compared with the eccentric phase (p<0.05). Conclusion: The current study suggests that the diagonal pattern of exercise may contribute to selective strengthening of the shoulder complex muscles and that the form of exercise should be tailored to the subject. It also suggests that diagonal exercises with concentric contractions tend to be more beneficial than eccentric contractions for overall muscle recruitment, but the effects vary for specific diagonal patterns.

• International Journal of Internet, Broadcasting and Communication
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• v.14 no.2
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• pp.183-191
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• 2022

The purpose of this study, the wearing conditions of functional pressure clothing applied with the thermotherapy device were determined by three types (NW, CW, TCW) and the difference in isokinetic strength, muscle activity around the forearm was investigated and the effects of products mixed with thermotherapy and pressure treatment were verified. Ten men in their 20s were selected as subjects, and all subjects were randomly assigned three wearing conditions, and wrist flexion/extension exercise was performed at 30° and 90° angular velocity in isokinetic equipment. Peak torque, average power, and EMG were measured during exercise in all conditions. For peak torque, CW was significantly highest at velocity of 30°/sec flexion. Average power showed no significant difference by condition. In the angular velocity of 90°/sec, flexion was significantly higher in CW and TCW than in NW. As a result, wearing clothes with pressure effect and heat effect can show high efficiency in high muscle strength development and fast contraction activity during low speed exercise, and it is thought that it can show improvement of exercise ability through efficient recruitment of motor unit.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.55-61
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• 2015

PURPOSE: The purpose of this study was to investigate recruiting order and onset time around shoulder muscle during the push-up according to the body tilting angle. METHODS: Twenty healthy young adult subjects were recruited for this study. They had no neurological and musculoskeletal disease. We used the sEMG for recording onset time of shoulder muscles. Shoulder Muscles were anterior deltoid(AD), posterior deltoid(PD), pectoralis major(PM), upper trapezius(UT). Body tilting angle were measured at 0 degree, 30 degree and 60 degree by using tilting table. Muscles contraction onset time were set by the push-up performed 3 times respectively. Mean of 3 measurements were used. And initiate onset time was decided by the Mean ${\pm}2$ SD in the threshold, more than 25ms. RESULTS: There were significant difference at 0 degree, 30 degree and 60 degree(p<.05). Muscles onset time were same order at 0 degree, 30 degree. UT occurred first of all contraction at 0 degree and 30 degree. And then contracted AD, PD, PM. But, at 60 degree, AD was the first contraction, and PM, UT, PD. CONCLUSION: Muscle recruitment order and onset time according to the body tilting was shown the difference when you do push-up. Therefore, this result, shoulder muscle recruitment pattern of according to the body tilting is different and it has to make effective shoulder exercise program.