• PNF and Movement
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• v.13 no.2
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• pp.103-109
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• 2015

Purpose: Abdominal breathing exercises are recommended to activate the breathing muscles and the pelvic floor muscles, as well as to increase postural alignment during exhalation. The purpose of this study was to clarify the effect of improving abdominal muscle strength on menstrual pain in women in their twenties using abdominal breathing exercises. Method: In this study, 32 female university students were included as the subjects. The subjects were divided into two groups based on the area of menstrual pain: lumbar pain (n=16) and lower abdomen pain (n=16). The abdominal breathing positions were divided into two positions, which included a hook lying position and hip and knee flexions at $90^{\circ}$ in the supine position. Exercises were used to strengthen the abdominal muscles during exhalation. Four sets of the exercises were completed three times a week over the course of eight weeks. The degree of pain was measured using the Numeric Rating Scale (NRS). Muscle thickness was measured using an ultrasound. Result: The thickness of the transverse abdominis (TrA) and internal oblique (IO) increased in the lower abdomen pain group. However, thickness of the external oblique (EO) did not increased following abdominal breathing. No significant difference in posture was identified in the lower abdomen group. TrA thickness increased significantly in the lumbar pain group. However, thickness did not increase significantly in the lumbar pain group. In addition, the lumbar pain group experienced no significant effects on posture. IO thickness increased following hip and knee flexions at $90^{\circ}$ in the lumbar pain group. Menstrual pain decreased following intervention in both groups. There was no significant difference in the degree of pain reduction between both groups. Conclusion: As examples of alternative medicine, abdominal breathing exercises may be effective in decreasing menstrual pain.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.804-813
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• 2018

Objective To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). Methods Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). Results According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. Conclusion HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

• PNF and Movement
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• v.17 no.2
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• pp.283-291
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• 2019

Purpose: The purpose of this study was to investigate the effects of trunk stability training on static balance and game records among archers. Methods: The subjects comprised 24 voluntary archers in middle and high school (aged 14-19 years). All the subjects received trunk stability training for an hour per day 3 days a week for 4 weeks. The Tetrax balance system was used to measure the stability index of the subjects' static balance. The subjects' game records were scored using a single FITA round system. All the subjects were measured before the intervention, 2 weeks into the intervention, and 4 weeks after the intervention, with a follow-up measurement 2 weeks later. Results: The results of this study showed that the stability index was significantly different across all the measuring positions after the intervention (p<0.05). Furthermore, the results of the measurements of the standing position with eyes open and closed were significantly different before the intervention compared to 4 weeks after the intervention (p<0.05). The archery position with the head turned to the left and eyes closed was also significantly different pre-intervention compared to 2 weeks after the start of the intervention (p<0.05). Additionally, the archery records were significantly different after the intervention (p<0.05), as well as before the intervention and 4 weeks after the intervention (p<0.05). Conclusion: Trunk stability training can improve static balance in archers. It may also be helpful in improving athletic performance and maintaining the life of the athlete. Accordingly, trunk stability training may prevent and resolve injuries through careful management when playing one-side sports.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.2
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• pp.236-250
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• 2019

Objectives: The purpose of this study was to investigate the effect of intensive rehabilitation programs on pain, range of motion (ROM), lumbar muscle strength, core muscle endurance, disability, and depression in patients with traumatic low back injuries and to compare the efficacy of this therapy with that of conventional rehabilitation therapy. Methods: The study was performed with a retrospective medical chart review of patients with traumatic low back injury referred to the rehabilitation center at the Daegu Hospital of the Korean Workers Compensation and Welfare Service. Forty-four patients were allocated to either the conventional rehabilitation group (CRG; n = 22) or the intensive rehabilitation group (IRG; n = 22). The CRG group patients, who received 30-min therapist-supervised physical therapy and modality therapy five times per week for four weeks, were compared with the IRG group patients, who received 60-min therapist-supervised physical therapy, 30-min therapist-patient 1:1 matching rehabilitation therapy, and modality therapy five times per week for four weeks. Outcome measures were a numerical rating scale, ROM, lumbar muscle strength, lumbar core muscle endurance, thickness of lumbar deep focal core muscle (transverse abdominis and lumbar multifidus), Oswestry disability index (ODI), and depression (Korean version patient health questionnaire-9). Results: There were statistically significant improvements after treatment in all outcome measures in both groups (p < 0.05). In the intergroup comparison, NRS scores on the activity and thickness of lumbar deep focal core muscles increased significantly more in the IRG than in the CRG (p < 0.05). There were no statistically significant intergroup differences in NRS scores on resting, ROM except left lateral bending, lumbar muscle strength, core muscle endurance, ODI, and depression. Conclusions: We could confirm the superior effectiveness of an intensive rehabilitation program compared to conventional rehabilitation therapy in patients with traumatic low back injuries.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.61-69
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• 2019

Purpose : The purpose of this study was to investigate the effects of Straight leg lifts (SLL) and double leg lowering (DLL) exercise on abdominal muscle activity, visual analog scale (VAS), and flexibility in patients with chronic low back pain (LBP). Methods : A total of 30 LBP patients were divided into two groups: those with SLL exercise group 15 (male=8, female=7) and those with DLL exercise group 15 (male=7, female=8). Before the intervention, the abdominal muscle activity, VAS, and flexibility were measured. After 4 weeks of intervention, the above variables were measured in the same way. The SLL exercise bends the leg $45^{\circ}$ in the supine position, and the DLL exercise was performed as opposed to SLL. At this time, the pressure biofeedback unit (PBU) was placed behind the lumbar to reduce the instability of the pelvis and muscles. The subjects were instructed to use the PBU to maintain the target pressure determined (40 mmHg) during the exercise. Results : The external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were significantly different in the SLL and DLL group, and EO, IO, and TrA activity improved more significantly increased in the DLL than SLL group (p<.05). The results on the VAS and flexibility were significantly different both group (p<.05). However, there was no significant difference between the groups (p>.05). Conclusion : SLL and DLL exercises in patients with LBP were able to confirm the increased activity of the abdominal muscles, decreased pain, and increased flexibility of the waist. In addition, DLL exercise is more effective in patients with LBP in terms of muscle activity.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.1-11
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• 2021

Purpose : The purpose of this study was to investigate the effect of single limb stance exercise according to the support surface on dynamic balance ability and abdominal muscle thickness. Methods : We recruited 28 healthy subjects in this study. Subjects were assigned to 2 groups by matching method. The control group was 5 males and 9 females, and single limb stance exercise was performed on the stable support surface. The experimental group consisted of 6 males and 8 females, and trained to stand on the unstable support. During the single limb stance exercise, the dominant foot was set as the foot that appeared numerically through the exercise of the dynamic balance meter (Biorescue). Single limb stance exercise along the supporting surface was maintained for 15 seconds and then rested for 15 seconds. It was repeated 5 times. Particularly, the balance exercise on the unstable support surface was sufficiently practiced. Independent t test was performed for comparison between groups. Paired t test was performed to compare before and after each group. Results : There was no difference between the control group and the experimental group in the comparison of dynamic balance ability (p>.05). However, there were significant differences before and after exercise in both the control and experimental groups (p<.05). Similarly, in the comparison of abdominal muscle thickness, there was a significant difference within each group, especially internal oblique and transverse abdominis (p<.05), and no difference between groups (p>.05). Conclusion : Based on these results, although there was no difference between the groups, in the experimental group, numerical increase in dynamic balance ability and abdominal muscle thickness was confirmed. Therefore, single limb stance exercise on the unstable support surfaces activates core muscles and has a positive effect on dynamic balancing ability.

• PNF and Movement
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• v.18 no.3
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• pp.415-424
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• 2020

Purpose: This study aimed to compare changes in abdominal muscle thickness in different standing postures with a handheld load between subjects with and without chronic low back pain (CLBP). Methods: Twenty subjects with CLBP and 20 controls participated in this study. Ultrasound imaging was used to assess the changes in the thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles. Muscle thickness in three different standing postures (standing at rest, standing with loads, standing with lifting loads) was compared with the muscle thickness at rest in the supine position and was expressed as a percentage of change in the thickness of the muscle. Results: While standing with loads, the change in IO muscle thickness in the CLBP patients increased more significantly than in the pain-free controls (p < 0.05). The standing with lifting loads posture showed a significant increase in the change in thickness of the TrA compared with the standing with loads posture (p < 0.05). In addition, the standing with lifting loads posture showed a significant decrease in the change in the thickness of the EO when compared with the standing with loads posture (p < 0.05). Conclusion: The automatic activity of the IO muscle in subjects with CLBP increased more than that of the pain-free controls in the standing with loads posture. These findings suggest that IO muscle function may be altered in those with CLBP while standing with loads. Additionally, TrA the activation level was found to be associated with increased postural demand caused by an elevated center of mass.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.324-331
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• 2022

Prior abdominal liposuction can be viewed as a relative or absolute contraindication to abdominally based autologous breast reconstruction given concerns for damaged perforators and scarring complicating intraoperative dissection. This systematic review aims to explore the outcomes of abdominally based breast reconstruction in patients with a history of abdominal liposuction. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided literature search was conducted using PubMed, Scopus, and Web of Science from the earliest available date through June 2020. Deep inferior epigastric perforator, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM), superficial inferior epigastric artery, and pedicled TRAM flaps were included for evaluation. Complications included total or partial flap loss, fat necrosis, seroma, delayed wound healing, and donor site complications. After inclusion criteria were applied, 336 non-duplicate articles were screened, yielding 11 for final review, representing 55 flaps in 43 patients. There was no instance of total flap loss, eight (14.5%) flaps developed partial loss or fat necrosis, three (5.4%) flaps had delayed wound healing, and two (4.6%) patients had donor site complications. Most authors (8/11) utilized some type of preoperative imaging. Doppler ultrasonography was the most used modality, and these patients had the lowest rate of partial flap loss or flap fat necrosis (8%), followed by those without any preoperative imaging (10%). In conclusion, this review supports that patients undergoing abdominally based autologous breast reconstruction with a history of abdominal liposuction are not at an increased risk of flap or donor site complications. Although preoperative imaging was common, it did not reliably decrease complications. Further prospective studies are needed to address the role of imaging in improving outcomes.

• Journal of Biomedical Engineering Research
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• v.43 no.3
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• pp.177-184
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• 2022

The purpose of this study was to present the IMU sensor based trunk stabilization exercise and to evaluate the changes in the muscle activity and thickness with non-specific low back pain patients (N=30). They were classified into two groups; lumbar stabilization exercise using IMU sensor (ILS), (n₁=20) and general lumbar stabilization exercise (GLS), (n₂=10). By comparing the difference between pre and post intervention via trunk muscle activity and muscle thickness, the significant differences were identified. Muscle activity was measured on external oblique (EO), internal oblique (IO), and multifidus (MF) by using surface electromyography (sEMG). Muslce thickness was measured on external oblique, internal oblique, transverse abdominis (TrA), and multifidus (MF) by using ultrasonography. sEMG activity was recorded at right side-bridge position. Each group performed the proposed lumbar stabilization exercise for 30 minutes a day, 5 times a week for 4 weeks. Trunk muscle activity was observed with a significant increase in the IO of ILS (p<.05) and a decrease in the MF of GLS (p<.05). Trunk muscle thickness was significantly increased in left EO and both IO of GLS (p<.05), and also significant increased right EO, both IO, both TrA, and both MF of the ILS (p<.05). In the future, a convergence approach of rehabilitation and engineering is needed to select a sensor suitable for rehabilitation purposes, study the validity and reliability of data, and produce appropriate rehabilitation contents.

• Physical Therapy Korea
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• v.29 no.3
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• pp.215-224
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• 2022

Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson's correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson's correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.