Background: To restore the trunk function of stroke patients who tend to experience trunk weakness, a single exercise intervention is usually applied. However, problems with the trunk remain even after such an intervention. To overcome this challenge, combining other intervention methods with an exercise is suggested during training. Objectives: To investigate the effect of breathing based abdominal draw-in technique on the thickness of the transversus abdominis muscle and trunk control in stroke patients. Design: Randomized controlled study. Methods: After designating a group that will perform the abdominal draw-in technique as Experimental Group I and another group that will perform the breathing based abdominal draw-in technique as Experimental Group II, the thickness of the transversus abdominis muscle and the trunk impairment scale (TIS) of the subjects were measured as pre-tests before the interventions and as post-tests after the six week intervention period. Results: In the within group comparison, there was a significant change in the thickness of the transversus abdominis muscle for both groups while the subjects performed the abdominal draw-in technique; a significant change was also noted in their TIS (P<.05) (P<.01). However, in the inter-group comparison, a significant difference was found only in the TIS between the two groups (P<.05). Conclusion: After the application of the breathing based abdominal draw-in technique, an efficient contractile response was observed even in the muscles around the abdomen of the subjects, which indicates that this technique is an intervention method that can more effectively improve trunk control.

Background: Stroke patients have weak trunk muscle strength due to brain injury, so a single type of exercise is advised for restoring functionality. However, even after intervention, the problem still lies and it is suggested that another intervention method should be applied with exercise in order to deal with such problem. Objectives: To Investigate the effect of bridge exercise combined with functional electrical stimulation (FES) on trunk muscle activity and balance in stroke patients. Design: Randomized controlled trial. Methods: From July to August 2020, twenty stroke patients was sampled, ten patients who mediated bridge exercises combined with functional electrical stimulation were assigned to experiment group I, and ten patients who mediated general bridge exercises were assigned to experiment groupⅡ. For the pre-test, using surface EMG were measured paralyzed rectus abdominis, erector spinae, transverse abdominis/internal oblique muscle activity, and using trunk impairment scale were measured balance. In order to find out immediate effect after intervention, post-test was measured immediately same way pre-test. Results: Change in balance didn’t show significant difference within and between groups, but muscle activity of trunk was significant difference rectus abdominis and erector spinae within groups I (P<.01), also between groups was significant difference (P<.05). Conclusion: Bridge exercise combined with FES could improve trunk function more effectively than general bridge exercise due to physiological effect of functional electrical stimulation.

Background: Patients with low back pain (LBP) experience misalignments in the center of pressure (COP) and muscle imbalances due to frequent onesided posture adjustments to avoid pain. Objectives: To identify the effects of Squat Exercises with Vertical Whole-Body Vibration on the Center of Pressure and Trunk Muscle Activity. Design: Randomized controlled trial. Methods: Thirty LBP patients with an imbalance in the COP were sampled and randomly assigned to an experimental group of 15 patients who under went an intervention involving squat exercises with vertical WBV and a control group of 15 patients who were treated via a walking intervention. As pretests before the interventions, the subjects’ COP was identified by measuring their stability index (ST), and erector spinae, rectus abdominis, transverse abdominis, gluteus medius muscle activity was analyzed by determining the % reference voluntary contraction (%RVC) value using surface electromyography while sit to stand. After four weeks, a post test was conducted to remeasure the same variables using the same methods. Results: Statistically significant differences were found in the ST (P<.01) and trunk muscle (P<.05, P<.001) in the experimental group before and after the intervention. In terms of the differences between the left- and right-side (RL) muscle activity, only the transverse abdominis (TrA) and gluteus medius (GM) exhibited statistically significant increase (P<.05). A comparison of the groups showed statistically significant differences in the TrA with respect to muscle activity (P<.05) and in the RLTrA and RLGM in terms ofthe difference between left- and right-side muscle activity (P<.01). Conclusion: Squat exercises with vertical WBV produced effective changes in the COP of patients with LBP by reducing muscle imbalances through the delivery of a uniform force. In particular, strengthening the TrA and reducing an imbalance in the GM were determined to be important factors in improving the COP.

Background: Stroke patients exhibit arm global synkinesis (GS), involuntary movement due to muscle weakness and irregular muscle tension. But currently there are few studies examined the effects of GS on activates of daily living in stroke patients. Objectives: To investigate the effects the effects of task-oriented bilateral movements, which promote brain plasticity and are based on neurological theory, using the unaffected arm and the affected arm. Design: Quasi-randomized trial. Methods: Twenty stroke patients were randomly assigned to experimental group I (n=10) and experimental group II (n=10). Before the intervention, arm GS was measured using surface electromyography, and the Motor Activity Log evaluated the quantitative and qualitative uses of the affected arm in daily life. The same items were measured four weeks later. Results: The changes in the GS of the arm of experimental group I showed statistically significant differences only in bending motions (P<.05). Both groups showed statistically significant differences in the amount of use (AOU) and the quality of movement (QOM) scores (P<.01). Comparing the groups, statistically significant differences in GS appeared during bending motions (P<.05), and in the AOU (P<.01) and the QOM scores (P<.05). Conclusion: The intervention in GS reduced the abnormal muscle tension of the affected side by increasing the use of the ipsilateral motor pathway, indicating its effectiveness in improving upper limb functions with smooth contraction and relaxation of the muscles.

Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl– Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant betweengroup difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.

Background: Although there are interventions available for the improvement of arm functions of patients with stroke, measuring changes in global synkinesis (GS) according to changes in the muscle activity of paretic and nonparetic side muscles is an important factor and studies to investigate such potential factors are evaluated necessary. Objective: To examine the correlation between the affected arm muscle activity and GS changes in patients with stroke. Design: Randomized controlled trial Methods: In order to measure muscle activities of 30 stroke patients, anterior deltoid, posterior deltoid, biceps brachii and triceps brachii of the affected arms were measured using surface electromyography (EMG) and for analyzing GS, biceps brachii and triceps brachi of the affected arms were measured using the same instrument. Results: When the correlations between the muscle activity and GS of the affected arm were analyzed, the results showed significant correlations between the posterior deltoid and the triceps brachii(p < .01) and between the triceps brachii and GS(p < .05). Conclusion: : The results of this study suggest that the efficient movements of the affected arms of stroke patients, it is possible to increase extensor activity by improving smooth antagonism of the arm.

Background: Stroke patients require arm movement exercising for various stimulations in standing position for various stimulations rather than in a sitting position because they require integrated skillful movements, such as stretching, holding, and controlling. Objective: This study was conducted to provide foundational clinical data about lower limb global synkinesis in stroke patients using arm movements in a standing position. Design: Randomized controlled trial. Methods: The subjects were divided into a control group (n = 10) and an experimental group (n = 10), and a pre-test was conducted to evaluate leg global synkinesis (GS) and balance. Intervention method is stretching an arm to hold a ball, repeating supination and pronation of the hand only while maintaining the arm extended as much as possible, repeating shoulder abduction and adduction while holding the pegboard. This was followed by a three-week intervention during which re-measurement was conducted in the same way as was done for the pre-test. Results: The control group showed a significant difference in GS and balance during plantar flexion (p<.05), and the experimental group showed a significant difference in GS and balance during all movements (p<.05, p<.01, respectively). There was a significant difference in GS and balance between the two groups during dorsiflexion (p<.05, p<.01, respectively). Conclusion: The findings demonstrate that human arm movements in a standing position can reduce GS in the affected limb, and balance can be improved by stimulating the surrounding tissues of the affected limb and changing them positively.

Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20- minute intervention once a day, four times a week, for four weeks. Participants’ motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.