• 대한물리의학회지
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• 제8권3호
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• pp.379-385
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• 2013

PURPOSE: This study is research about deep trunk muscles (DTM) that is important and serve to control the movement of the trunk to provide stability during movement for human. In this study, trying to prove a change of DTM of aging in the ultrasound image. METHODS: We measured via an ultrasound image during rest and contraction of DTM in 42 young and 48 old people, and then we measured the change of thickness and symmetry. RESULTS: Symmetry showed a significant difference only external oblique (EO) in the young(p<.05). In the elderly, it was found that ratio of contraction was greater transverse abdominis than EO. CONCLUSION: I considered it could lead to improvement of activity of daily life by applying intervention for recovery of motor control of TrA for the elderly in clinical practice.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.3-10
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• 2012

The free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) and deep inferior epigastric perforator (DIEP) flaps involve transferring skin and subcutaneous tissue from the lower abdominal area and have many features that make them well suited for breast reconstruction. The robust blood supply of the free flap reduces the risk of fat necrosis and also enables aggressive shaping of the flap for breast reconstruction to optimize the aesthetic outcome. In addition, the free MS-TRAM flap and DIEP flap require minimal donor-site sacrifice in most cases. With proper patient selection and safe surgical technique, the free MS-TRAM flap and DIEP flap can transfer the lower abdominal skin and subcutaneous tissue to provide an aesthetically pleasing breast reconstruction with minimal donor-site morbidity.

• The Journal of Korean Physical Therapy
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• 제16권4호
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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.

• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.115-119
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• 1999

In breast reconstruction with a free flap following mastectomy, the recipient vessels most widely used are in the axillary system, which limits flap movement and flexibility in breast shaping. In addition, scarring and fibrosis can make dissection of the vessels difficult. We have performed 43 breast reconstructions using a free transverse rectus abdominis myocutaneous(TRAM) flap. In 10 cases out of 20 delayed reconstruction, we anastomosed to the internal mammary vessels rather than subscapular system. There has been no flap failure. The surgical techniques, advantages and limitations of the internal mammary system are presented. The internal mammary vessel are compared with the axillary vessels as a recipient vascular system.

• The Journal of Korean Physical Therapy
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• 제27권5호
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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.

• 대한물리의학회지
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• 제12권1호
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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.

• 대한물리의학회지
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• 제12권1호
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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.

• 대한통합의학회지
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• 제4권3호
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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.

• 대한물리의학회지
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• 제12권2호
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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.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.542-547
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• 2014

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.