Push-up plus has been advocated for increasing the activity of the serratus anterior muscle, the most critical scapular stabilizer. However, no previous study has reported the possibility of compensatory motion on the part of the pectoralis major, which could substitute for the action of the serratus anterior during push-up plus. The aim of the current study was to investigate the immediate effect of electromyography (EMG) biofeedback of the pectoralis major muscle on the pectoralis major, upper trapezius, and serratus anterior muscles during push-up plus. Fourteen healthy young subjects voluntarily participated in this study; each subject performed push-up plus from the quadruped position, in two conditions (i.e., with or without visual and auditory biofeedback). Surface EMG was used to measure pectoralis major, serratus anterior, and upper trapezius activity. A paired t-test was used to determine any statistically significant difference between the two conditions. Additionally, effect size was calculated to quantify the magnitude of EMG biofeedback in each muscle. Visual and auditory feedback reduced pectoralis major muscle activity significantly (p=.000) and increased the serratus anterior muscle activity significantly (p=.002), but did not induce a significant difference in upper trapezius muscle activity (p=.881). Thus, it is concluded that the visual and auditory feedback of pectoralis major muscle activity can be used to facilitate serratus anterior muscle activity during push-up plus.
The purpose of this study was to assess visual biofeedback's influence on trunk muscles' (EMG) activity and endurance holding time for correct position during whole-body tilt exercise. For the study, we recruited 14 volunteers who showed no symptom of lumbar disease during medical tests. We measured the EMG activity of their rectus abdominis, external abdominal oblique, internal abdominal oblique and erector spinae muscles, and their endurance holding time for correct position during anterior and posterior whole-body tilt under two conditions: whole-body tilt with and without visual biofeedback. Resistance with gravitational force on the trunk during whole-body tilt was applied by using a device that had a monitor on which the subjects could check their alignment and that sounded an alarm if a subject's alignment collapsed. The study showed an increase in the EMG activity of external abdominal oblique, internal abdominal oblique/rectus abdominis ratio and endurance holding time for correct position during both anterior and posterior whole-body tilt with visual biofeedback compared with without visual biofeedback (p<.05). We suggest that the whole-body tilt exercise with visual biofeedback could be a beneficial strategy for selectively strengthening the internal abdominal oblique muscle and minimizing the rectus abdominis muscle's activity while maintaining correct alignment during whole-body tilt exercise.
This study was to investigate the positive effects of specially designed trunk-stabilization exercise program on lower extremity balance of elderly with history of leprosy. In this participants, lower extremity functions has been undermined by the development of damage in peripheral nerves. A total of 40 elderly with history of leprosy were divided into 2 groups of equal size (): a group that participated in the exercise program, and a control group that did not exercise but did continue to engage in normal daily activities (including walking). The exercise group exercised for 60 minutes 2 days a week for 12 weeks. Static balance ability was measured by asking study participants to a one leg standing test: dynamic balancing ability was measured with a tandem walking test and a timed up-and-go test. The participants in the exercise program and the control group were tested before and after completion of the exercise program for comparison, and then divided according to their ability to feel sensory in the soles of their feet into the categories of normal sensory group: group with sensory loss in one foot: and group with sensory loss in both feet. The participants in the exercise program showed a positive, statistically significant difference in static balance compared with the control group (p<.05) as measured using the one leg standing test. Similarly, the participants in dynamic balance (p<.05) as measured using the tandem walking and timed up-and-go tests. Finally, these improvements were related to the severity of sensory loss in the soles of the feet for all study participants.
The aim of this study was to compare electromyography activity for long and lateral heads of triceps brachii muscle according to forearm positions during different triceps strengthening exercises. The muscle activities for long and lateral head of triceps brachii were measured by surface electromyography. Fifteen healthy volunteers participated for this study and performed elbow extension in three different elbow extension exercises (elbow extension in a supine position; EES, elbow extension with shoulder abduction at 90 degrees in a prone position; EESA, and elbow extension with one arm at the side of the trunk in a prone position; EESP) and forearm positions (supination, neutral, and pronation). A two-way repeated measures ANOVA was used to compare the effects of the exercise positions and forearm positions. The EMG activities of the long head of the triceps brachii increased significantly during EESP with forearm supination, whereas the activity of the lateral head of the triceps brachii increased significantly during EESA with the forearm in a neutral position (p<.05). The results of this study suggest that exercise positions and forearm positions should be considered for selectively strengthening the long and lateral heads of triceps brachii muscles.
The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.
The purpose of this study was to compare electromyography (EMG) activity for the middle and lower trapezius muscle according to various shoulder abduction angles. Thirty healthy male subjects were recruited for this study. Each subject performed three repetitions of horizontal abduction at 75˚, 90˚, 125˚, 160˚, and 180˚ of shoulder abduction angle in a prone position. Surface EMG activity was recorded from the middle and lower trapezius while the subjects held for five seconds at a predetermined position. The EMG activity was normalized using the maximal voluntary isometric contraction (MVIC) elicited using a manual muscle testing technique. A repeatedly measured ANOVA was performed by Bonferroni's post hoc test. The EMG activity of the middle and lower trapezius was significantly different among shoulder abduction angles (p<.05). The greatest level of muscle activity for the middle and lower trapezius were demonstrated at and of shoulder abduction angle, respectively. These results suggest that middle and lower trapezius strengthening exercise and manual muscle testing should be performed at different shoulder abduction angles.
The purpose of this study was to identify the effects of manual facilitation and a stick on lumbar and hip joint flexion angles in subject with lumbar flexion syndrome during forward bending from a sitting position. Fifteen subjects with lumbar flexion syndrome were recruited for this study. As a pretest, all subjects performed three repetitions of bending the trunk forward until the tips of their fingers touched the target bar. After this pretest, the subjects practiced the forward bending of the trunk 10 times, using either manual facilitation or a stick. Then, as a posttest, all subjects repeated the pretest procedure. The flexion angles of lumbar spine and hip joint during forward bending in a sitting position were measured using a three-dimensional motion analysis system. A paired t-test was used to determine the statistical differences between pre-test and post-test flexion angles and pre- and post-test flexion angle differences between forward bending with manual facilitation and forward bending with a stick. The level of statistical significance was set at p=.05. The results of the study showed that the angle of the lumbar flexion decreased significantly and the bilateral hip flexion angle increased significantly when performing forward bending with stick and manual facilitation. Furthermore, the angle of lumbar flexion decreased significantly and the angle of bilateral hip flexion increased significantly in forward bending with a stick compared to forward bending with manual facilitation. The findings of this study indicate that both forward bending with manual facilitation and sticks could be used to prevent excessive lumbar flexion and increase hip flexion, and that forward bending with a stick is more effective than forward bending with manual facilitation for inducing lumbar spine and hip joint angle changes.
After stroke, many people have problems with balance during movement. Balance is essential for the optimal functioning of the locomotor system and the performance of many activities of daily living. The Functional Gait Assessment (FGA) is a clinical tool for evaluating balance ability during walking. The test consists of ten tasks, seven tasks of the Dynamic Gait Index and three additional tasks. The purpose of this study was to evaluate the reliability and internal consistency of data obtained with the Korean version of the FGA when used with people after suffering a stroke. One-hundred participants, at least three months poststroke and able to walk at least six meters with or without a walking aid, participated in the study (age range=30~83 years; ). Two physical therapists and two physical therapy students rated the FGA. Intrarater and interrater reliability of the FGA were assessed using kappa statistic and intraclass correlation coefficients (2,1). The internal consistency of the FGA was assessed using the Cronbach alpha. The Cronbach alpha was good (=.86~.93). The intrarater (intraclass correlation coefficient=.92~.95) and interrater reliability (intraclass correlation coefficient=.91, .95) of the total scores administered by the therapists and students were good, whereas the reliability for single item scores when administered by the physical therapists was moderate to good (kapa value=.42~.97). This study found that intrarater and interrater reliability for total FGA scores and internal consistency were good. Therefore, the Korean version of the FGA can be used as a reliable tool to assess the functional gait performance of patients after stroke.
The purpose of this study was to compare the anaerobic threshold (AT) between subjects with and without non-specific chronic low back pain (NCLBP). The patient group included 15 women with NCLBP. The normal group included 15 women without NCLBP who were age-, height-, weight-, and activity level-matched. The subjects performed a Balke treadmill protocol which was symptom-limited progressive loading test. Their heart rate (HR), ventilatory gas and metabolic equivalents (METs) were measured using the automatic breath gas analyzing system. After the test, each subjects' ratings of perceived exertion (RPE) were evaluated. The visual analog scale (VAS) was assessed pre- and post-test. The independent t-test and Wilcoxon's signed-rank test were used for analysis of the data. Time, HR, the volume of oxygen consumption (), relative , and METs at the AT level of the patient group were significantly lower than those of the healthy group (p<.05). However, there were no significant differences in RPE, VAS, and breathing frequency at the AT level (p>.05). The findings of this study indicate that patients with NCLBP had a lower aerobic fitness than healthy subjects. Thus, implementation of rehabilitation program to increase aerobic fitness may be considered in patietns with NCLBP, and further studies are required to determine the etiological factors of decreased aerobic fitness.
Osteoarthritis is a degenerative joint disease and is led to physical disability. Yet the development of effective disease-modifying treatments has lagged. In this study, I examined the effect of physical therapeutic intervention through microcurrent stimulation and attempt to find which degree of intensity, either 25 or 500 with a regular 5 pps pulse, is more effective in the osteoarthritis. Osteoarthritis was induced with a mixture of 2% carrageenan and 2% kaolin in 26 male Sprague-Dawley rats. The mixture (0.1 ) was injected into the intra-articular capsule of knee joint once a week for three weeks. Five animals did not show degenerative changes by radiological findings and excluded in the following experiment. Osteoarthritic animals were randomly divided into 3 groups (, , =7/each): untreated, treated with 25 , treated with 500 . All experimental groups received microcurrent stimulation for four weeks (15 min/day, 5 days/week). The ethological inspection of foot print analysis on the walking corridor was accomplished every week. Histological preparations and immunohistochemical staining with insulin-like growth factor-1 were also done in the articular cartilages. All of these parameters were compared with those of osteoarthritic control group (n=7). The ethological inspection of foot print analysis revealed that changes of walking track (paw width) and stride length was significantly increased in both experimental groups. The better results were observed in experimental group treated with 25 intensity without significance than group treated with 500 . Histological preparations disclosed that routine hyaline cartilage of articular surface were altered to fibrous cartilage in untreated group and experimental group treated with 500 intensity. But a little changes were seen in experimental group treated with 25 intensity. Immunolocalization of insulin-like growth factor-1 was simultaneously decreased according to the duration of osteoarthritis, and did not show significant difference among the groups. In this study discovered that the microcurrent stimulation, especially 25 intensity, had a positive effect by the ethological inspection, histological and immunohistochemical stainings. These results suggest that microcurrent stimulation with low-intensity might be effective in the promotion of healing process for the osteoarthritis.
This study was implemented to verify the feasibility of motor function recovery and the appropriate period for therapy. The research began with spinal laminectomy of 40 white rats of Sprague-Dawley breed and induced them spinal crush injury. Following results were obtained by using the modified Tarlov test (MTT), Basso, Beattle, Bresnahan locomotor rating scale (EBB scale) and modified inclined plate test (MIPT). First, the measurement using the MTT confirm that the most severe aggravation and degeneration of functions are observed two days after induced injury, and no sign of neuromotor function recovery. Second, better scores were achieved by open-ground movement group on BBB locomotor rating scale test, and weight-bearing on inclined plate group show better performance on MIPT. Third, both BBB and MIPT scale manifested the peak of motor function recovery during 16th day after the injury and turn into gradual recovery gradient during 16th to 24th. Fourth, the control group showed functional recovery, however, the level of recovery was less significant when compared with group open-ground movement group and weight-bearing on inclined plate group. Hence, it was clearly manifested that the lumbar region of the spinal cord had shown the best performance when its functions were measured after the execution of specific physical training; therefore it indicated the possibility of learning specific task even in damaged lumbar regions. Thus it is expected to come out with better and more effective functional recovery if concentrated physical therapy was applied starting 4 days after the injury till 16 days, which is the period of the most active recovery.