Background: To evaluate whether extracorporeal shock wave therapy (ESWT) in the pain point is a more effective treatment than the trigger point for myofascial pain syndrome (MPS) of the upper trapezius. Objects: The purpose of this study was to compare the most effective areas when applying extracorporeal shock wave therapy. Methods: A total of 30 patients with MPS were randomly assigned to the trigger point in the ESWT (n = 15) and pain point ESWT (n = 15) groups. Interventions in both groups were performed in one session, i.e., 2,000 shocks with 1.5 bar intensity. Pain and function were assessed using the visual analog scale (VAS) and cervical range of motion (ROM) and based on mechanical muscle properties. Statistical analysis was performed using the repeated measures two-way analysis of variance to determine the significance probability between pre- and post-test. Results: Changes in mechanical muscle properties were not statistically significant between the two groups. However, VAS and cervical ROM showed statistically significant differences at pre- and post-intervention, regardless of the group (p < 0.05). Conclusion: Although no significant difference was observed in the intervention effect, applying an extracorporeal shock wave to the pain point rather than the pain trigger point should be considered in order to save time in effectively and accurately identifying the pain trigger point and site.

Background: Investigation in gender differences of kinetics and kinematics for individuals with patellar femoral pain syndrome (PFPS) was not sufficiently performed. Objects: The purpose of this study is that whether there is a difference depending on gender from muscle activity and strength and knee valgus angle during controlled single-leg squat which is widely used as clinical movement test for the patient with PFPS. Methods: 20 young adults (10 men, 20.0±2.1 years; 10 women, 20.4±2.1 years) with PFPS were voluntarily recruited in this study. Muscle activity and strength and knee valgus angle were collected during single-leg squat. Independent t-test and Mann-Whitney test were used to compare the differences between groups of male and female. Results: Rectus femoris (t=-2.204, p=.041) and vastus medialis oblique (t=-2.151, p=.045) muscle activity of women were significantly higher than male group. Normalized muscle strength of hip and knee muscles showed a significant difference between men and women (p<.05). Valgus angle of the knee in women (t=-2.450, p=.025) were increased significantly than men. Conclusion: The therapist would consider the characteristics of these gender differences during performing movement test, exercise, and education for the individuals with PFPS.

The aim of this study was to investigate the effect of hip external rotation angle on pelvis and lower limb muscle activity during prone hip extension. Sixteen healthy men were recruited for this study. Each subject performed an abdominal drawing-in maneuver (ADIM) in a prone position, and extended the dominant hip at three different hip external rotation angles (0°, 20°, 40°) with a 30° hip joint abduction. Activity of the gluteus maximus (G Max), gluteus medius (G Med), and hamstring (HAM) and the G Max/HAM and G Med/HAM ratios were determined with surface electromyography (EMG). The EMG signal was normalized to 100% maximum voluntary isometric contractions (MVICs) and expressed as %MVIC. Data were analyzed by one-way repeated analysis of variance (alpha level=.05) and the Bonferroni post hoc test. Significant differences in G Max and G Med muscle activity were noted among the three different hip external rotation angles. G Max muscle activity increased significantly at both 40° (p=.006) and 20° (p=.010) compared to a 0° hip external rotation angle. G Med muscle activity increased significantly at 20° (p=.013) compared to a 40° hip external rotation angle. The G Max/HAM activity ratio increased significantly at both 40° (p=.004) and 20° (p=.014) compared to a 0° hip external rotation angle. The G Med/HAM activity ratio increased significantly at 20° (p=.013) compared to a 40° hip external rotation angle. In conclusion, 40° and 20° hip external rotation angles are recommended to increase G Max activity, and 20° hip external rotation is advocated to enhance G Med muscle activity during prone hip extension with ADIM and 30° hip abduction in healthy subjects.

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.