• Title/Summary/Keyword: rectus abdominis

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Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection

  • Hashimoto, Ichiro;Takaku, Mitsuru;Matsuo, Shinji;Abe, Yoshiro;Harada, Hiroshi;Nagae, Hiroaki;Fujioka, Yusuke;Anraku, Kuniaki;Inagawa, Kiichi;Nakanishi, Hideki
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.253-257
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    • 2014
  • Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to $33.6kg/m^2$ (mean, $23.1{\pm}3.74kg/m^2$). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.

Anatomical Study for Vascular Distribution of the Perforator of Deep Inferior Epigastric Artery in Koreans (한국인에 있어 깊은아래배벽동맥(Deep Inferior Epigastric Artery)의 천공지(Perforator)에 관한 해부학적 연구)

  • Kim, Jee Hoon;Lee, Paik Kwon;Rhie, Jong Won;Kim, Deog Im;Han, Seung Ho
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.28-35
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    • 2008
  • Purpose: The pedicle of transverse rectus abdominis myocutaneous(TRAM) flap and deep inferior epigastric arterial perforator flap is deep inferior epigastic artery (DIEA) and accurate anatomic knowledge about perforator of DIEA is very important for the elevation of these flap. The authors investigated a detailed vascular network of perforator of DIEA in Koreans. Methods: 24 fresh cadavers were studied. Among them, 15 were examined based on the plain X-ray examination for the distribution and location of perforator of DIEA. And 9 fresh cadavers were examined based on the 3-dimensional computed tomography(CT) study for the distance between ending point of perforator of DIEA and mother artery, the distance between most medial mother artery and midline, the distance between most lateral mother artery and midline, and the running type of perforators of DIEA. Results: Based on the plain X-ray examination, suitable(external diameter$${\geq_-}0.5mm$$) perforators of DIEA are located between the level of umbilicus and 8 cm below it. Based on the 3D-CT study, average distance between the ending point of perforator of DIEA and the mother artery is 30.26 mm on the left, 28.62 mm on the right, respectively. The average distance between most medial mother artery and midline is 17.13 mm on the left, 15.76 mm on the right, respectively. The average distance between most lateral mother artery and midline is 56.31 mm on the left, 50.90 mm on the right, respectively. The main running course of suitable perforators of DIEA is type a, which is a direct musculocutaneous perforator vessel from main vascular axis passing outward to join the subdermal plexus, directly. Conclusion: 3-dimensional computed tomography study as well as plain X-ray examination provided more accurate and detail informations about perforators of DIEA in Koreans. These informations will help us understand the detailed vascular anatomy and operation with ease and safe in the lower abdomen of Koreans.

An Experimental Study on the Effect of Supporting Vest for Musculoskeletal Disorders in Low Back (허리 근골격계질환 예방 보조 조끼의 효과에 대한 실험적 연구)

  • Kim, Yun-Jeong;Jang, Jee-Hun;Cho, Yoe-han;Jeong, Jin-Hyoung;Cheong, Ha-Young;Lee, Sang-Sik
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.13 no.3
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    • pp.219-225
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    • 2020
  • With the aging population, the prevalence of musculoskeletal disorders in the elderly continues to increase. In addition, musculoskeletal disorders are the third most common social and economic loss among occupational illnesses in Workers' compensation insurance benefits as of 2015 standard and are also common among workers. In this study, a vest that can assist in the prevention and treatment of musculoskeletal disorders of the waist was produced, and it is intended to confirm the presence or absence of the effect through experiments. Diseases of the waist are closely related to core muscles. Therefore, the produced vest was made in a form that supports the core muscles. Before and after wearing the vest for effectiveness verification, the While performing 10-times of the Mackenzie exercises, a waist extension exercise, collected the EMG data of the internal oblique, Rectus abdominis, and Erector spinae, which correspond to the core muscles. The collected data were analyzed through the electromyography analysis program RM-3 to obtain RMS values for 10-times measurements of each muscle and to compare the average values. After comparing the data, to verify the significance, the technical statistical value of the measurement result was calculated and the average difference was verified through PASW ver18.0, And the paired t-test is performed on the experimental results to perform statistical processing. and Statistical processing was performed by setting the significance level to α=.05.

Effect of hip positions in frontal plane on abdominal muscle activities during bridging exercise (교각운동시 이마면에서 엉덩관절 위치가 배근육 근활성도에 미치는 영향)

  • Lee, Won-Hwee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.224-230
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    • 2019
  • The purpose of this study is to investigate the effect of the hip positions in frontal plane on abdominal muscle activities during bridging exercise. Twenty six subjects who have healthy conditions were asked to perform bridging exercise in three starting positions which are hip abduction, neutral and hip adduction. We used surface electromyography to compare the activities of both external oblique, internal oblique and rectus abdominis muscle. We analyzed the data by using repeated one way ANOVA, The alpha level was set at 0.05. The results showed that the muscle activities of both sides of external oblique, and internal oblique were significantly different among three starting positions. The activity of both sides of rectus abdominis were insignificantly different among three positions. The muscle activities of both sides of external oblique muscle and left internal oblique in bridging exercise with hip adduction position were significantly greater than hip neutral positions. The muscle activity of right internal oblique in bridging exercise with hip abduction positions. Our results suggest that bridging exercise with hip adduction position is recommended to lumbar stabilization exercise and the factor of hip position is important for controlling exercise intensity when designing bridging exercise program.

Analysis of trunk and lower extremity muscle activity according to the compensation of arm during bridge exercise (교각운동시 팔의 보상작용에 따른 몸통 및 하지근육 활성도 분석)

  • Oh, Gku Bin;Kim, Se Hee;Kim, Ye Eun;An, Jun Sung;You, Si Yeon;Jung, Sang Jin;Cho, Ye Bin;Ju, Jin Han;Cho, Ki Hun
    • Journal of Korean Physical Therapy Science
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    • v.29 no.3
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    • pp.12-20
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    • 2022
  • Background: The purpose of this study was to investigate the changes of trunk and lower extremity muscle activity according to the compensation of arm during bridge movement of healthy subject. Design: Cross-sectional Study. Methods: Twenty healthy subjects participated in this study. The subjects performed bridge exercise with 3 different arm positions(arm abduction 45°, 90° and cross-arms) and measured the muscle activity of the trunk and lower extrimity. During bridge exercise with 3 different arm positions, trunk (rectus abdominis, erector spinae) and lower extrimity muscle activity (gluteus medius, biceps femoris, tibialis anterior) were measured using wireless surface EMG. Results: Rectus abdominis and gluteus medius muscle were most activated during bridge exercise with arm abduction 90° and erector spinae and biceps femoris muscle were most activated during bridge exercise with arm abduction 45°. In addition, tibialis anterior muscle was most activated during bridge exercise with arm cross. However, these difference in muscle activity according to the arm position was not statistically significant. Conclusion: As a result of this study, we think that the change in arm position does not induce sufficient instability to increase the muscle activity of the trunk and lower extremity muscles. Therefore, various approaches for inducing instability of the support surface for increasing muscle activity when applying bridge movement in clinical practice should be explored.

The Effect of Mechanical Horseback-Riding Training according to Velocity on Trunk Muscles Thickness in Healthy Adult

  • Lim, Jae-Heon;Cho, Woon-Su;Park, Jang-Sung
    • The Journal of Korean Physical Therapy
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    • v.27 no.5
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    • pp.281-286
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    • 2015
  • Purpose: The study was to determine whether mechanical horseback-riding training according to velocity may improve trunk muscles thickness in healthy adults. Methods: Twenty healthy adults participated in this study. The subjects were divided into 2 groups as follows: 10 subjects in high velocity mechanical horseback-riding training (MHRT) and 10 subjects in low velocity MHRT. Subjects in all groups performed a total of 18 sessions 3 times a day for 20 minutes and this experiment lasted for 6 weeks. Mann-Whitney and Wilcoxon Signed Rank test were used in analysis the results of trunk muscle thickness. Ultrasonography was performed to evaluate for thickness of rectus abdominis (RA), external oblique (EO), internal oblique (IO), transverse abdominis (TrA), erector spine (ES), and multifidus (MF) in trunk muscles. Results: Results on the changes of EO, IO, and ES of high velocity MHRT showed a significant increase after 6 weeks (p<0.05). Regarding the changes of EO, IO, ES, TrA, and MF of low velocity MHRT, a significant increase was observed after 6 weeks (p<0.05). The differences in change of trunk muscle thickness before training, after 6-week training between groups, TrA and MF of low velocity MHRT were significantly higher (p<0.05). Conclusion: Based on the results of the current study, the velocity of MHRT was shown to affect change of trunk muscle thickness in healthy adults. In particular, low velocity MHRT may serve as a useful method to provide for TrA, MF thickness improvement related to trunk stabilizers.

Influence of Supplementary Verbal Encouragement According to the Gender on Abdominal Muscle Activation during Crunch Exercise in Healthy Subjects: A Cross-Sectional Pilot Study (크런치 운동 시 성별에 따른 부수적인 청각적 격려 적용이 정상인의 복부 근육 활성도에 미치는 영향: 단면 예비 연구)

  • Kim, Chang-Yong;Lee, Ji-Hyeon;Kang, Jeong-Hyeon;Kim, Hyeong-Dong
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.1
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    • pp.15-24
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    • 2017
  • PURPOSE: The purpose of this study was to investigate the effects of supplementary verbal encouragement according to the gender on the activation of abdominal muscles during performance of crunch exercise in healthy subjects. METHODS: A Total of 32 healthy subjects (15 male and 17 female) were randomly allocated to two conditions, crunch exercise with Ki-hap and verbal encouragement with same gender (CKVS) and crunch exercise with Ki-hap and verbal encouragement with different gender (CKVD). The interventions were conducted over three trials in each condition, and measurements were performed on each subject by one examiner in three trials. The activation of rectus abdominis, external oblique, internal oblique, and transverse abdominis muscles were evaluated using electromyography (EMG) during performance of crunch exercise with Ki-hap and verbal encouragement with same gender or different gender, respectively. RESULTS: The results showed that there were no significantly difference in the activation of all abdominal muscles in those of the CKVS compared with the CKVD (p>.05). The results also showed that there were no significantly difference in the ratio of muscle activation at global muscle to that at local muscle between two conditions (p>.05). CONCLUSION: These findings demonstrated that application of the supplementary verbal encouragement by gender does not affect to activate the abdominal muscles of subject to perform a movement, at the same time, it would suggest positive evidence for improving activation of abdominal muscles.

Effects of Heel Contact Methods of Stair Ascent on Abdominal Muscle Activation in Healthy Subjects: A Cross-Sectional Pilot Study (계단 오르기 시 발뒤꿈치 접지 방법이 정상인의 복부 근육 활성도에 미치는 영향: 단면 예비연구)

  • Kang, Jeong-Hyeon;Kim, Chang-Yong;Kim, Jae-Hwan;Kim, Hyeong-Dong
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.1
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    • pp.1-8
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    • 2017
  • PURPOSE: This study was to determine the changes of abdominal muscles activation according to the heel contact methods of stair ascent in healthy young adults. METHODS: 33 healthy young subjects (mean age: $26.37{\pm}9.72$ years, age range: 20-32 years) volunteered under two conditions. They were performed stair ascent with heel contact and without heel contact. The effects of heel contact methods were assessed using the surface electromyography (sEMG) analysis during stair ascent for activation of abdominal muscles (internal oblique; IO, transverse abdominis; TrA, external oblique; EO rectus abdominis; RA). The interventions were conducted over three trials in each method, and measurements were performed on each subject by one examiner in three trials. RESULTS: Our results revealed that there were significantly greater increase in the EMG activation of IO and TrA muscles in the performance of stair ascent with heel contact (p<.05) compared to those of stair ascent without heel contact. The results also showed that there were greater decrease in the ratio of abdominal muscle activation in those of stair ascent with heel contact compared with stair ascent without heel contact. CONCLUSION: These findings demonstrated that the method of stair ascent with heel contact would suggest positive evidence for improving activation of abdominal muscles.

Effect of the Balance Exercise on the Unstable Surfaces for the Vital Capacity in Healthy Adults: A Preliminary Study (불안정한 지지면에서의 균형운동이 건강한 성인의 폐활량에 미치는 효과: 사전 연구)

  • Kim, Taeho;Park, Hankyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.4 no.3
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    • pp.17-25
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    • 2016
  • Purpose : This study attempts to examine the effect of the balance exercise on the unstable surfaces for the vital capacity in healthy adults. Methods : A total of 13 subjects was randomly divided into a breathing exercise training group (n=7) and a breathing and balance exercise training group (n=6). Changes in vital capacity and respiratory muscle activity were measured before and after the intervention. The intervention was performed three times a week for four weeks. Forced vital capacity (FVC), forced expiratory volume at one second (FEV1) and maximal voluntary ventilation (MVV) were used as measurement tools for the vital capacity test. Electromyography (EMG) was also used to examine respiratory muscle activity. Result : The breathing exercise training group showed significant improvement in terms of FVC, FEV1 and external oblique (EO), and transverse abdominis/internal oblique (TrA/IO) of MVV. The breathing and balance exercise training group showed significant improvement in terms of FVC, MVV and EO, TrA/IO of FVC and rectus abdominis (RA), EO, and TrA/IO of MVV. However, in comparing changes in vital capacity and respiratory muscle activity before and after the training, the breathing exercise training group and the breathing and balance exercise training group showed a significant difference in terms of MVV. Conclusion : This study is as a preliminary study to find out the relation between a balance exercise and a vital capacity, it is considered to require a further study with several revisions of subjects, duration and time for an intervention.

The Effect of Trunk Strengthening Exercise using Oscillation on Trunk Muscle Thickness and Balance (진동을 이용한 몸통 근력 운동이 몸통근 두께와 균형에 미치는 영향)

  • Cho, Woon-Su;Park, Chi-Bok;Lim, Jae-Heon
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.91-101
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    • 2017
  • PURPOSE: The aim of this study was to verify the effect of trunk strengthening exercise using oscillation by comparing trunk muscle thickness, as well as balance of healthy adults during exercises performed with an oscillatory device and non-oscillatory device. METHODS: Twenty-two participants were randomly assigned to one of two groups: the trunk strengthening exercise using oscillation (TSEO) group (n=11) or the trunk strengthening exercise using non-oscillation (TSEN) group (n=11). Subjects in all groups performed the exercises three days per week for 6 weeks. All subjects performed four types of exercises: pull over, seated twist, power push, and diagonal power plank. Trunk muscle thickness of the rectus abdominis (RA), internal oblique (IO), external oblique (EO), transverse abdominis (TrA), and multifidus (MT) were measured with an ultrasonography. The balance ability were evaluated using the Romberg test with eyes open, eyes closed, one-leg standing test (OLST), and limits of stability (LOS). All tests were performed before the intervention, as well as after 6 weeks and 8 weeks of exercises. RESULTS: There was a significant difference of RA, IO, TrA, and MT according to the main effect of the time (p<.05). There was a significant difference of IO and LOS according to interaction effect between the time and group (p<.05). CONCLUSION: As intended, the cyclic forces induced by the oscillating device did increase trunk muscle thickness. However, the effect was limited and significant only for the IO muscle. Combining trunk strengthening exercise with oscillation appears to be more effective in improving dynamic balance.