• Journal of Korean Physical Therapy Science
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• v.25 no.3
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• pp.25-31
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• 2018

Background: The purpose of this study was to find out how changes in knee angles in stable and unstable support surfaces affect the muscle thickness of core muscles. Methods: The subjects of this study were 25 male adult. Each knee angle of 120, 90 and 60 degrees, they were performed bridge exercise on the stabilized surface and on the unstable support surface using TOGU, and measured the muscle thickness of the external and internal oblique muscle and the abdominal muscles through ultrasound images. Results: There was no significant difference between the thickness of the rectus abdominis and the internal oblique muscle depending on the support surface and the knee joint bending angles. However, there was a significant difference between the external oblique muscle and the transverse abdominis muscle by knee joint flexion angle. Conclusion: While the muscle thickness of the core muscle was not significantly affected by each support surface during the bridge exercise, there were significant changes in the core muscle as a result of changes in knee angle.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.444-449
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• 2021

Objective: The purpose of this study is to observe the change in the thickness of abdominal muscles when electrical muscle stimulation (EMS) is applied to the abdomen during rest and abdominal muscle exercise to investigate the effect of EMS applied to the abdomen on the superficial and deep muscles thickness. Design: Cross sectional design. Methods: Twenty healthy subjects participated in this study. Subjects were performed resting position, resting position with EMS, curl-up and curl-up with EMS. The electrode of the EMS belt is attached to the abdominal wall between the 12th rib and iliac crest. The thickness of abdominal muscles including rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were captured in each position by ultrasound image during expiration. All subjects were performed four positions randomly. Data were analyzed using repeated ANOVA with the level of significance set at 𝛼=0.05. Results: The muscle thickness of RA, EO, IO and TrA were significantly different at each position (p<0.05). The thickness of all abdominal muscles increased significantly when curl-up than curl-up with EMS. Both RA and EO thickness were significantly increased at resting position than resting position and EMS were combined(p<0.05). But IO and TrA thickness were decreased at resting position when EMS were combined. Conclusions: The results suggest that EMS activates superficial abdominal muscles RA and EO. Therefore, abdominal strengthening exercise combined EMS can activate abdominal muscles and can be applied to various patients and rehabilitation in clinical practice.

• The Journal of Korean Physical Therapy
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• v.36 no.1
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• pp.1-8
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• 2024

Purpose: The purpose of this study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) abdominal muscle strengthening exercise on the activity, posture, and body function of clients with abdominal muscle weakness after cesarean section. Methods: PNF abdominal muscle strengthening exercise was applied to one patient with abdominal muscle weakness after cesarean section. PNF abdominal muscle strengthening exercise was applied five times a week for four weeks. The 5-time supine-to-long sitting test (5-TSLST) and supine-to-stand test (SST) were used to measure activity, and the pelvis tilt angle test (PTAT) and anterior head translation test (AHTT) were used to measure posture. Body function was assessed using the transverse abdominis muscle strength test (TAMST), the internal oblique and external oblique muscle strength test (IOEOMST), and the rectus abdominis muscle strength test (RAMST). Results: Activity, posture, and body function were improved post-intervention. Conclusion: The study verified that PNF abdominal muscle strengthening exercises are effective when applied to patients with abdominal muscle weakness after cesarean section. The findings of this study provide useful data for future interventions in patients with abdominal muscle weakness after cesarean section.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.374-378
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• 2013

Background: Incisional pain is particularly troublesome after hysterectomy. A method called transversus abdominis plane block (TAPB) has shown promise in managing postoperative pain. In this study, we evaluated the analgesic efficacy of ultrasound-guided TAPB after hysterectomy at different time points and at each time point separately for 48 hours. Methods: Forty-two patients (ASA I, II) who were electively chosen to undergo total abdominal hysterectomy were divided into 2 groups, control (group C) and intervention (group I). Twenty-one patients underwent TAPB (group I) and 21 patients received only the standard treatment with a fentanyl pump (group C). Both groups received standard general anesthesia. For patients in group I, following the surgery and before emergence from anesthesia, 0.5 mg/kg of ropivacaine 0.2% (about 20 cc) was injected bilaterally between the internal oblique and transverse abdominis muscles using sonography. Pain scores using the Visual Analogue Scale (VAS) and drug consumption were measured at 2, 6, 12, 24, and 48 hours after TAPB. Results: There were no significant differences in demographics between the two groups. VAS scores appeared to be lower in group I, although there was no interaction with time when we compared mean VAS measurements at different time points between group I and group C (P > 0.05). The amount of fentanyl flow was consistently higher in group C, but when we compared the two groups at each time point separately, the observed difference was not statistically significant (P < 0.053). The incidence of vomiting was 10% in group I and 28% in group C. There were no complaints of itching, and sedation score was 0 to 3. There were no complications. Conclusions: This study showed that TAPB did not result in a statistically significant decrease in VAS scores at different time points. TAPB did lead to decreased fentanyl flow, but when we compared the two groups at each time point separately, the observed difference was not statistically significant.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.73-80
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• 2015

PURPOSE: The purpose of this study is to compare ultrasound images of trunk muscles according to gender in healthy subjects. METHODS: Twenty six subjects(13 males and 13 females) were enrolled in this study. The thickness of trunk muscles was measured for transverse abdominis (TrA), external oblique abdominis (EOA), internal oblique abdominis (IOA), and multifidus (MF) using ultrasound. The thickness of the muscles was measured for the length of cross-section except for fascia. The muscle thickness wasmeasured at the both side, then the mean value was calculated. Also, each of trunk muscle wasanalysed by echodensity, white area index. RESULTS: As a results, there was significant difference in muscle thickness of EOA, IOA according to gender (p<0.05). The male was significant increase than female of EOA, IOA in muscle thickness. There was significant difference in echo intensity of TrA, MF according to gender(p<0.05). The female was significant increase than male of TrA, MF in echo intensity. There was significant difference in white area index of EOA according to gender(p<0.05). The female was significant increase than male of EOA in white area index. CONCLUSION: The findings of this study suggest that healthy male have a greater EOA, IOA trunk muscle thickness than female. However, the difference of muscle quality between male and female was showed through thisexperiment. Therefore, the ultrasonography images will be useful tool for seeing quantitative and qualitative difference of trunk muscles according to gender.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.216-221
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• 2019

Purpose: This study examined the effect of visual feedback squat on the core muscle thickness of young adults experiencing back pain. Methods: Thirty adult men and women who experienced back pain were assigned randomly to 15 members of the visual feedback squat group (VSG) and 15 of the normal squat group (NSG) to train three times a week for a total of eight weeks. The core muscle thickness was compared prior to the test for four weeks and eight weeks after the test by dividing it into warm-up exercise, main exercise, and 10 minutes finishing exercise. Before, and four weeks and eight weeks later, the thickness of the core muscle was compared using an ultrasonic imaging system. Repeated measured ANOVA was performed to compare the groups, and a Bonferroni test was performed as a post-hoc test to assess the significance of the timing of the measurements in each group according to the periods. An independent t-test was conducted to test the significance between the groups according to the measurement points. Results: A significant change in the main effects of time and interactions of the time difference in muscle thickness of transvers abdominis were observed between the visual feedback squat and control groups according to the measurement point (p<0.05). No significant difference in the muscle thickness of both muscles was observed between the groups with the exception of the right abdominis (p>0.05). Conclusion: These findings suggest that visual feedback squat exercise is expected to have positive effects on the development of transverse abdominis in core muscles.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.11 no.3
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• pp.207-214
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• 2017

The problem of trunk stability is a major factor in back pain.. Abdominal draw in maneuver(ADIM), One of the trunk stabilization exercises to relieve lumbar instability, is a method of inducing selective contraction of the transverse abdominis associated with anticipatory posture control among the abdominal stabilization muscles. ADIM is usually performed with a visual feedback by applying a pressure biofeedback unit(PBU) under the lumbar at the supine position, which is not functional compared to the sitting position. This study was conducted to investigate the effect of ADIM applied in supine and sitting position on 31 healthy men and women. In each posture, muscle activity was measured by rectal abdominis (RA), external oblique (EO), transverse abdominis (TrA)/internal obilique (IO) and erector spinae (ES) using wireless EMG. In the result, there was no significant difference between RA and EO between the two postures and there was a significant difference between TrA / IO and ES. In both postures, the activity of TrA/IO was higher than that of RA, and the effect of ADIM was shown to be the same, whereas TrA/IO and ES showed higher activity in sitting position. This means that the activity of the muscles involved in the postural stability and lumbar stability is increased further in the sitting position. Therefore, ADIM in sitting, which can be applied more easily in daily life, is useful for improving lumbar stability.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.40-43
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• 2009

Purpose: Extensive midface defect following total maxillectomy with orbital exenteration and cheek skin resection should be three dimensionally reconstructed with a large flap that have a sufficient volume of tissue and multiple skin islands. We describe our transverse rectus abdominis myocutaneous(TRAM) free flap with three skin islands which was successfully used in this situation. Methods: A 58-year-old man was performed enbloc total maxillectomy including orbital contents and wide cheek skin because of invasive maxillary squamous cell carcinoma. He was immediately reconstructed with TRAM flap that was designed not vertical but transverse fashion for providing sufficient skin area. Also, deepithelialization procedure making for multiple skin islands was done in flap insetting period when appropriate modification according to the intraoperative situation was possible. Dead space was completely obliterated by bulky muscular tissue, and three skin islands were used for lining of lateral nasal wall, palatal surface, and cheek skin restoration. Results: Postoperative course was satisfying. Maintaining of proper ipsilateral nasal airway, loss of rhinolalia and oronasal regurgitation of food particles, and restoration of cheek contour were successfully obtained. Conclusion: We report clinical experience of threedimensional reconstruction using free TRAM flap after total maxillectomy with orbital exenteration.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.173-180
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• 2013

As microvascular techniques continue to improve, perforator flap free tissue transfer is now the gold standard for autologous breast reconstruction. Various options are available for breast reconstruction with autologous tissue. These include the free transverse rectus abdominis myocutaneous (TRAM) flap, deep inferior epigastric perforator flap, superficial inferior epigastric artery flap, superior gluteal artery perforator flap, and transverse/vertical upper gracilis flap. In addition, pedicled flaps can be very successful in the right hands and the right patient, such as the pedicled TRAM flap, latissimus dorsi flap, and thoracodorsal artery perforator. Each flap comes with its own advantages and disadvantages related to tissue properties and donor-site morbidity. Currently, the problem is how to determine the most appropriate flap for a particular patient among those potential candidates. Based on a thorough review of the literature and accumulated experiences in the author's institution, this article provides a logical approach to autologous breast reconstruction. The algorithms presented here can be helpful to customize breast reconstruction to individual patient needs.

• Journal of Korean Physical Therapy Science
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• v.15 no.4
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• pp.61-74
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• 2008

Background: Purpose of this study is mat exercises and sling exercises that based on proceeding studies for exercising protocol for spinal stabilization. Methods: We analyze many other bibliographies and result of studies. Results: The vertebrae stabilization practices are formed on intra-abdominal pressure and converted into isolation of our body and limbs gradually through co-contraction training of transverse abdominis, pelvic floor muscle and diaphragm. Also, for prevention of low back pain and relapse, it is diverted to reflex muscle contraction training as well as functional integration. What is better, it should carry out with Activity of Daily Living. Conclusion: We should feel the necessity of it, more effective recognition training of local muscle for chronic low back pain patients. Besides, it is suggested that we should import measurable equipment and go hands with discipline.