This present study investigated the effects of the abdominal drawing-in maneuver (ADIM) and chin tuck (CT) on middle thoracic erector spinae, lower thoracic erector spinae, and lumbar erector spinae muscle activity during three prone thoracic extension (PTE) exercises. Twelve healthy subjects performed preferred PTE, ADIM PTE, and ADIM-CT PTE. Surface electromyography was used to collect data on the muscle activity of dominant middle and lower thoracic erector spinae muscles and the lumbar erector spinae. Middle and lower thoracic erector spinae muscle activity significantly increased when ADIM and CT was performed (p<.05). However, lumbar erector spinae muscle activity significantly decreased in ADIM PTE compared to preferred PTE (p=.017) and significantly increased in ADIM-CT PTE compared to ADIM PTE (p=.004). In conclusion, ADIM-CT PTE effectively increased middle and lower thoracic erector spinae muscle activity, and ADIM PTE decreased lumbar erector spinae muscle activity. Hence, ADIM PTE could be a recommended exercise maneuver to strengthen thoracic erector spinae without over activation of lumbar erector spinae.
Posterior shoulder muscle tightness is frequently observed in shoulder impingement syndrome because tightness in the posterior portion of the shoulder muscles can cause anterior and superior translation of the humeral head in relation to the glenoid fossa. The purpose of this study was to determine the immediate effects of soft tissue massage on acromiohumeral distance (AHD), anterior translation of the humeral head, and glenohumeral (GH) range of motion (ROM) in subjects with posterior shoulder muscle tightness. Twenty-seven subjects with greater than difference in the range of GH horizontal adduction between right and left sides were recruited. The range of GH horizontal adduction and internal rotation were measured by a digital inclinometer. The AHD and anterior translation of the humeral head were measured using ultrasonography. A paired t-test was used to compare AHD, anterior translation of the humeral head, and the range of GH horizontal adduction and internal rotation before and after soft tissue massage. The results showed that AHD increased significantly (p<.05) and the anterior translation of humeral head decreased slightly, but not significantly (p=.40) after the soft tissue massage. Furthermore, the ROM of horizontal adduction and internal rotation in the GH joint increased significantly after the soft tissue massage (p<.05). These findings indicate that soft tissue massage on posterior shoulder muscle tightness is an effective method to increase AHD and ROM in the horizontal adduction and internal rotation of the GH joint.
This study examined the effects of custom-made foot orthotics on the temporal-spatial gait parameters in children with cerebral palsy. Twenty spastic bilateral cerebral palsy (spastic CP) children (11 boys and 9 girls) participated in this study. GAITRite was used to examine the velocity, cadence, step length differential, step length, stride length, stance time, single support time, double support time, base of support, and toe angle while walking with and without foot orthotics. The differences in temporal-spatial parameters were analyzed using paired t-test. The significance level was set at .05. The velocity, cadence, both step lengths, both stride lengths, both bases of support and right toe angle significantly increased when the children with spastic CP with foot orthotics compared to without foot orthotics (p<.05). The step length differential between the two extremities, left stance time and left single support time, significantly decreased with foot orthotics (p<.05). Right stance time, right single support time, both double support times and left toe angle showed little change (p>.05). This study demonstrated that foot orthotics were beneficial for children with spastic CP as a gait assistance tool.
The aim of this study was to investigate the effectiveness of self-stretching exercises for iliotibial band (ITB) (Side-lying; right hip and knee were flexed to support the pelvis while left hip was extended and adducted, Standing A; side-bending of the trunk on standing with crossed leg, Standing B; same as Standing A, except the hands were clasped overhead and shifted right side, and Standing C; same as Standing B, except moving the arms diagonally downward) to help determine the most effective self-stretching method to stretch ITB. Twenty-one healthy subjects who do not have ITB shortness from Yonsei University (14 men and 7 women) between the ages of 18 to 28 years voluntarily participated. Ultrasound was performed to measure the thickness of the ITB between the long axis of the ITB and the level parallel to the lateral femoral epicondyle during four self-stretching exercises. All data were found to approximate a normal distribution. We used a one-way repeated-measures analysis of variance (ANOVA) to compare the thickness of the ITB among all self-stretching exercises. The level of significance was set at =.05. The ANOVA was followed by Bonferroni's correction. The overall mean of ITB thickness was mm ( standard deviation) in resting status. The change in the ITB thickness in percentages between the tested position of each self-stretching exercises and resting status was significant (p<.05) (Side-lying with 95% confidence interval [CI]=21.99~31.25%; Standing A with 95% CI=22.09~36.84%; Standing B with 95% CI=37.31~50.81%; Standing C with 95% CI=48.25~59.29%). Results indicated significant differences among four self-stretching exercises except Side-lying versus Standing A (p<.01). Based on these findings, the Standing C self-stretching exercise was the most effective in stretching the ITB thickness among four types of ITB self-stretching exercises. Additionally, the Side-lying self-stretching exercise using gravity to stretch the ITB is recommended as a low-load (low-intensity), long-duration stretch.
The purpose of this study was to investigate the quantitative data of downward pulling tension in subjects with scapular downward rotation syndrome (SDRS) before and after 6-week self scapular upward rotation exercise (SURE) program. Eleven subjects with bilateral SDRS. The downward pulling tension(DPT) was measured digital tension-meter. The tension force data were collected using a surface electromyography before and after a 6-week self-scapular SURE program. The significance of difference between pre- and post-program was assessed using a paired t-test, with the level of significance set at =.05. The results showed that significant differences between pre- and post-SURE program were found for DPT (p<.05). These findings suggest that 6-week self SURE program is effective for reducing DPT in subjects with SDRS. Additionally, our DPT measurement can be useful for maintaining shoulder position and providing quantitative data between pre- and post-SURE program during passive correction of scapular position test.
The aim of this study is to compare the effect of abdominal drawing-in maneuver (ADIM) on lower trapezius (LT), serratus anterior (SA), and erector spinae (ES) muscle activity during arm lifts in prone and standing positions. Twenty healthy subjects were recruited, and NoraxonTeleMyo 2400T was used to collect electromyographic signals from the LT, SA, and ES muscles. A two-way repeated analysis of variance (ANOVA) used a significance level of .05. If a significant interaction was found, pairwise comparisons were performed with a Bonferroni adjustment (.05/4=.013). The results of the study were as follows: 1) In LT, no significant ADIM by position interaction was found (=.356, p=.558). There was a significant main effect for ADIM. LT muscle activity with ADIM was significantly greater compared with muscle activity without ADIM (=82.863, p<.001). There was also a significant main effect for position. LT muscle activity in the prone position was greater compared with muscle activity in the standing position (=116.401, p<.001). 2) In SA, significant ADIM by position interaction was found (=8.687, p=.008). There were significant differences in all pairwise comparisons. The greatest SA muscle activity was observed in the standing position with ADIM. 3) In ES, significant ADIM by position interaction was found (=122.473, p<.001). The lowest ES muscle activity was elicited in the standing position with ADIM. Based on these results, ADIM is advocated in the prone position to increase LT muscle activity. In addition, it is concluded that arm lifts in the standing position with ADIM offer the most favorable combination for reducing ES muscle activity and increasing SA muscle activity.
Ely's test is commonly used to assess rectus femoris muscle flexibility. however, a reliability limit of this test was demonstrated by a previous study. In this study, we present an alternative method using an application for a digital horizontal level in a smartphone (DHLS) to complement the reliability limit of Ely's test. The aim of this study was to examine the reliability of Ely's test using DHLS on the pelvis, compared to using visual observation (VO) of pelvic and hip motions. Nineteen patients with lumbar extension-rotation syndrome were recruited for this study. An examiner examined the rectus femoris flexibility (both pass/fail and goniometer scoring) through Ely's test using both DHLS and VO. A retest session was completed two hours later for within-day reliability and seven days later for between-day intra-rater test-retest reliability. Results showed higher Kappa values for pass/fail scoring and higher intraclass correlation coefficient values for goniometer scoring in Ely's test using DHLS, compared to using VO. Measurement error and Bland and Altman plots further demonstrated the degree of intra-rater variance during Ely's test using DHLS in a clinical setting, compared to using VO. These results demonstrated that Ely's test using DHLS showed acceptable reliability compared to using VO. Ely's test using DHLS could be widely used for measuring the rectus femoris muscle flexibility in patients with lumbar extension-rotation syndrome, although the inter-rater reliability needs to be established first.
The trochanteric prominence angle test (TPAT) has been used to measure the femoral anteversion angle between the tibial crest and the vertical line. However, the exact anatomical reference of the tibial crest has not yet been identified in the literature. Thus, the purposes of this research were twofold: first, to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest (the proximal tibial crest, the proximal third of tibial crest, and the proximal half of tibial crest) and, second, to determine inter-and intra-rater reliabilities of the femoral anteversion angle measured at these three different anatomical references of the tibial crest during the TPAT. We recruited 14 healthy subjects, and a total of 28 legs were examined. The TPAT was measured using a digital inclinometer. A 1-way repeated-measure analysis of variance was used to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest, and intraclass correlation coefficients (ICCs) were calculated to determine reliability. The femoral anteversion angle measured at the proximal tibial crest was significantly higher than that at the proximal third of the tibial crest and the proximal half of the tibial crest. The inter-and intra-rater reliabilities of femoral anteversion angle were measured at three anatomic references of the tibial crest were all found to be high during the TPAT (ICC=.9 0~.98). In conclusion, clinicians should recognize that the different degrees of the femoral anteversion angle could be measured when different anatomical references of the tibial crest were used, and that reliabilities were high when an exact anatomical reference of the tibial crest was used during the TPAT.
The purpose of this study was to identify the effects of tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching exercise on the lumbopelvic movement patterns during active prone hip lateral rotation (HLR) in subjects with lumbar extension rotation syndrome accompanying TFL-ITB shortness. Eleven subjects (9 male and 2 female) were recruited for the two-week study. A three dimensional ultrasonic motion analysis system was used to measure the lumbopelvic movement patterns. The TFL-ITB length was measured using the modified Ober's test and was expressed as the hip horizontal adduction angle. The subjects were instructed how to perform TFL-ITB self-stretching exercise program at home. A paired t-test was performed to determine the significant difference in the angle of lumbopelvic rotation, movement onset time of lumbopelvic rotation, TFL-ITB length, and LBP intensity before and after the two-week period of performing the TFL-ITB self-stretching exercise. The results showed that after the intervention, the lumbopelvic rotation angle decreased significantly (p<.05), the movement onset time reduced significantly (p<.05), and LBP intensity decreased slightly but not significantly (p=.07). The hip horizontal adduction angle increased significantly (p<.05) after the intervention. These findings indicate that TFL-ITB stretching exercise increased TFL-ITB length, decreased lumbopelvic rotation angle, and delayed the movement onset time of lumbopelvic rotation after two-weeks. In conclusion, the TFL-ITB self-stretching exercise performed over a period of two weeks may be an effective approach for patients with lumbar extension rotation syndrome accompanying TFL-ITB shortness.