This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p＜05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

The purpose of this study was to determine the effect of contralateral hip adduction (CHA) on the muscle activity of lumbar stabilizers and the angle of pelvic lateral tilting during hip abduction in side lying. Twenty healthy male subjects with no medical history of lower extremity or lumbar spine disorders were recruited for the study. Subjects randomly performed preferred hip abduction (PHA) and hip abduction with contralateral hip adduction in side lying. The muscle activities of the dominant side rectus abdominis, external oblique, internal oblique, quadratus lumborum, gluteus medius, and non-dominant side hip adductor longus were measured during PHA and CHA by using a surface electromyography (EMG) system. Pelvic lateral tilting motion was measured by using a three-dimensional motion analysis system. Data on EMG and pelvic motion were collected at the same time during PHA and CHA. A paired t-test was used to compare EMG activity and the angle of pelvic lateral tilting in the two exercises. The study found that the EMG activities of all muscles were more increased significantly in CHA than PHA condition. The angle of pelvic lateral tilting was more decreased significantly in CHA than PHA condition. These findings suggest that CHA could be recommended as a hip abduction exercise for activating lumbar stabilizers and decreasing compensatory pelvic lateral tilting motion.

The purpose of this study was to test the effect of Gastrocnemius and Low Back-muscle isotonic exercise on static•dynamic standing balance during the period of 4 weeks. This study was two groups pretest-posttest design. Nineteen subjects who were over 22 years old were randomly assigned to either the experimental group that received the Gastrocnemius muscle exercise(n=9) or the low back muscle exercise(n=10) : The former group performed isotonic exercise(plantar flexion), the latter group performed isotonic exercise(trunk extension) a total of 18 times for three times per week for four weeks. Two groups also performed static and dynamic balance before the exercise and 4weeks after the exercise. The data were analyzed by using the paired t-test and independent t-test. The results were as follows: As compared with change of dynamic balance performance capacity at two groups, a significant difference was shown in the test(p<.05), but not in static balance(p>.05). Also, a significant difference of balance between groups was not shown in the test. In this study indicated that gastrocnemius and low back muscle isotonic exercise will have positive impact on standing balance.

The purpose of this study is to identify the effective lumbar area exercise program to prevent falls of the elderly by dividing 14 female elders over 65 living in Daegu into two groups such as resistance exercise group and resistance & stabilization exercise group, and applying a 60 minute exercise program three times a week for 12 weeks. The followings are the results. First, both of resistance exercise and resistance & stabilization exercise brought improvement of lumbar strength and there was no significant difference between two groups. Second, there was no significant difference in lower limb strength in resistance exercise group but resistance & stabilization exercise group showed significant increase in lower limb flexor strength. To make a summary of the above results, it can be said that 12 weeks’ resistance & stabilization exercise is effective to the lumbar strength and lower limb strength of the elderly. Accordingly, if combining resistance exercise and stabilization exercise appropriately, we can build a successful preventive program which even the elderly who cannot perform resistance exercise easily can follow.

The purpose of this study is to examine the changes on lumbar muscle strength in relation to 12-week pilates mat exercise of elderly women. The participants are chosen for 17 people who is an experimental group and 14 people who is an comparison group who except wastage and pilates mat exercise program was gradually intensify applied three times a week, during 12 weeks. The peak torque of flexion was increased(p<.01) and the difference of ratio of agonist to antagonist was decreased(p<.001). The total work of flexion and extension had significant increased(p<.001) at 120°/sec. As a result of all these, it was judged as positive effect for body composition, basal physical fitness and lumbar muscle strength after pilates mat exercise in 12 weeks. These positive effects showed that pilates mat exercise could got conclusions that mitigated the musculoskelctal disorders, slow down the progress of disorders, helped as a functions of physical.

The purpose of this study was to provide a practical guide to the proper way of lifting a patient using various types of stretcher that rescue crews use by analyzing the load on the lumbar region. The experiment was conducted with working male and female rescue crews. Having mixed groups of gender complete tasks such as lifting, moving, and unloading a patient using four different types of stretcher, we recorded variations of the lumbar bending angle and calculated the load on the lumbar region using 3D SSPP. The data showed, in terms of the lumbar bending angle, it was greater when only females were involved in the work, and there were very significant differences in the angle depending on the types of stretcher used and body sizes of each subject. In the analysis of the load on the lumbar based on the bending angle, NIOSH was over the recommended limit in certain groups. Utilizing the analysis, it is recommended, in the medium and long term, to improve equipments for rescue personnel and to guide them to the proper way of working.

The purpose of this study was to compare the slouched and upright sitting positions on lumbar joint reposition error (LJRE). Twenty subjects without low back pain were recruited for this study and, using a random number table, were randomly assigned to two groups; the upright sitting position group (UP group) and the slouched sitting position group (SP group). UP group was first asked to sit in an upright position and the SP group to sit in a slouched position as an intervention, and then the LJRE of both groups was measured at the neutral sitting position (lumbar flexion ). The measurement of the LJRE was repeated after one day. The sitting positions were performed for five minutes each and the LJRE was measured using an electronic goniometer. An independent t-test was used to compare the LJRE of both groups after each sitting position and after one day. The results of this study showed that the LJRE after an intervention in the UP group was lower than in the SP group (p<.05) and the LJRE after one day in the UP group was lower than in the SP group (p<.05). The findings of this study indicate that the upright sitting position can be applied to decrease LJRE, compared with the slouched sitting position. These findings also support that the upright sitting position reduces the potential for proprioceptive loss.

This study investigated the effects of axillary crutch length on trunk muscle activity and lumbo-pelvic-hip complex movements during crutch gait. Eleven healthy men participated in this study. The participants performed a three-point gait with optimal, shorter, and longer crutch lengths. Weight-bearing (WB) side was determined as the dominant leg side. The electromyography (EMG) activity of the bilateral rectus abdominis (RA) and erector spinae (ES) muscles and lumbo-pelvic-hip complex movements were monitored using a three-dimensional motion system with wireless surface EMG. Differences in the EMG activity of RA and ES muscles and range of motion (ROM) of lumbar spine, pelvis, and hip among conditions were analyzed using one-way repeated-measures analysis of variance, and a Bonferroni correction was conducted. There was less RA muscle activity on the WB side under the optimal crutch length condition compared with shorter and longer crutch length conditions (p<.05). The EMG activity of the RA muscle on the non-WB side and ES muscle on the WB side were significantly decreased under the optimal crutch length condition compared with shorter crutch length condition (p<.05). No significant differences in the EMG activity of the ES muscle on the non-WB side and ROM of lumbo-pelvic-hip complex were found among conditions (p>.05). These findings indicate that the optimal crutch length improves the trunk muscle efficiency during crutch gait.

The purpose of this study was to assess the influence of the duration of smartphone usage on cervical and lumbar spine flexion angles and reposition error in the cervical spine. The study included 18 healthy smartphone users (7 males and 11 females). We measured the kinematics of the upper and lower cervical and lumbar spine flexion angles and the reposition error of the upper and lower cervical spine after 3 s and 300 s smartphone use in sitting. A paired t-test was used to compare the effects of the duration of smartphone usage on the kinematics of cervical and lumbar spine flexion angles and reposition error. The flexion angles of the lower cervical and lumbar spine and the reposition error in the upper and lower cervical spine were significantly increased after 300 s smartphone of use (p<.05). However, the flexion angle of the upper cervical spine was not significantly different between the 3 s and 300 s smartphone of use (p>.05). These findings suggest that prolonged use of smartphones can induce changes in cervical and lumbar spine posture and proprioception in the cervical spine.

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.

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.

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.

This study was performed to compare the muscle activity of lumbar stabilizers between stoop and semi-squat lifting techniques at different lifting loads. Twenty healthy subjects (9 males, 11 females) were recruited for this study. Muscle activity of external obliques (EO), internal obliques (IO) and lumbar multifidus (LM) muscle was measured by surface electromyography during stoop and semi-squat lifting at different lifting loads (10%, 20%, and 30% of the subject's body weight). A one-way repeated measure ANOVA was applied. The results showed that EMG activity of EO was significantly increased with a load of 30% of body weight compared to 10% and 20% of body weight in both lifting techniques (p<.05). Muscle activity of LM was significantly increased in 20% compared to 10% and 30% compared to 10% of subject's body weight in stoop lifting and the muscle activity of LM was significantly increased in 20% compared to 10%, 30% compared to 20%, and 30% compared to 10% of the subject's body weight in semi-squat lifting (p<.05). However, there was no significant difference in activity of IO according to lifting loads in both lifting techniques. There were no significant differences in muscle activity of EO, IO, and LM between stoop and semi-squat technique (p>.05). Therefore, the results of this study suggested that the EO can contribute to increase the lumbar stability during stoop and semi-squat lifting at 30% of body weight rather than at lower loads, and the LM seems to act as counteractor to imposed loads during stoop and semi-squat lifting with increasing loads.

The purpose of this study was to compare the muscle activity of the abdominal and lumbar multifidus during unilateral prone hip extension on the floor and on a round foam roll. Fifteen healthy participants were recruited. They were instructed to perform a unilateral hip extension on the floor and on a round foam roll in the prone position. Surface electromyography (EMG) signals were recorded from bilateral lumbar multifidus (LM), external oblique (EO), and internal oblique (IO) muscles. A paired t-test was used to compare muscle activity, with the level of significance set at =.05. The results showed that bilateral LM, EO, IO EMG activity during right-hip extension on a round foam roll was greater than that on the floor, and EMG activity of bilateral LM, right EO, and left IO during left-hip extension on a round foam roll was greater than that on the floor (p<.05). These findings suggest that the unilateral hip-extension exercise on a round foam roll can be used to activate the lumbar multifidus and abdominal oblique muscles and causes a different increasing pattern between the two lifting sides.

The lumbar multifidus muscle, which can be separated into deep fascicles (DM) and superficial fascicles (SM), is important for lumbar segmental stability. However, no previous studies have investigated the effect of lumbar stabilization exercises on the thickness of DM and SM. Thus, the purpose of this study was to assess DM thickness after three different lumbar segmental stabilization exercises. In total, 30 healthy male participants were recruited and randomly assigned to one of three exercise groups: hollowing in the quadruped position (H-Quad), contralateral arm and leg lift (CALL), and bilateral arm and leg lift (BALL). Each lumbar segmental stabilization exercise was conducted over 4 weeks. Ultrasonography was used to compare the DM and SM thickness before and after the 4 weeks of exercise. A mixed-model analysis of variance using Scheffe's post-hoc test was used for statistical analysis. The results showed a significant effect for the measurement time (before vs. after 4 weeks of exercise) in the DM (F=31.26, p<.05) and SM (F=4.56, p<.05). At the end of the 4 weeks, the DM thickness had increased significantly in the H-Quad exercise group, and the SM thickness had increased significantly in the CALL and BALL exercise groups. Also in the BALL exercise group, the SM thickness was greater compared with that in the H-Quad exercise group. These findings suggest that the thickness of the DM and SM were increased by different types of lumbar segmental stability exercise after 4 weeks.

The purpose of this study was to determine the effect of contralateral hip adduction (CHA) on thickness of lumbar stabilizers during hip abduction in side-lying. Twenty healthy subjects without back pain were recruited for this study. The thickness of transverse abdominis (TrA), internal oblique (IO) and quadratus lumborum (QL) were measured by ultrasonography. Pelvic lateral tilting motion was measured using a three-dimensional motion analysis system. Measurements were performed at rest position (RP), preferred hip abduction (PHA) and abduction with contralateral hip adduction (CHA) in side-lying at the end of expiration. During the measurements, subjects were asked to maintain steady trunk alignment without hand support. Thickness of TrA and IO was significantly greater in CHA than in PHA and RP conditions. There was no significant difference in thickness of TrA and IO between PHA and RP conditions. Medio-lateral (M-L) thickness of QL was not significant between PHA and CHA conditions. Anterio-posterior (A-P) thickness of QL in PHA and CHA significantly decreased compared to RP condition. Angle of pelvic lateral tilting was significantly decreased in CHA compared to PHA condition. In conclusion, CHA can be recommended for increasing trunk stability without compensatory pelvic motion during hip abduction exercise in side-lying.

The purpose of this study is to examine the effect of stabilization, resistance exercise, and combined exercise for lumbar on balance and walking ability of elderly. This study selected 22 subjects of over 65 years old elderly women who satisfy the study condition from A, B and C Senior Citizen's Center, in Daegu. The subjects were divided into groups; 7 for resistance exercise group, 8 for stabilization exercise group, and 7 for combined exercise group(resistance and stabilization exercise). The exercises were conducted for 60min a day, three times a week for 12 weeks. Balance and walking ability were checked before the exercise, 6 weeks later, and 12 weeks later. First, all lumbar muscle strengthening exercises were effective for static balance which changed according to exercising period. In dynamic balance, the resistance exercise group showed significant improvement in sit to stand. Stabilization exercise group showed significant improvement in all factors. The combined exercise group showed significant improvement in sit to stand and timed up and go. There was no difference between the exercise types. Second, the resistance exercise group showed significant change in Cadence which changed according to exercising period. The combined exercise group showed significant improvement in all factors. Between the exercise types, combined exercise was a bit more effective than resistance exercise. According to the result of 12 weeks of lumbar muscle exercise, combined exercise is considered to be the most effective exercise to prevent fall as it helps balance and walking ability slightly more than other exercises. Therefore, this study can understand the risk factors for fall accidents that frequently occur among elderly and adopt the combined exercise to prevent fall which in turn will prevent secondary problems occur from fall accidents and improve quality of life of elderly.

The purpose of this study was to establish the reliability and validity of the passive lumbar extension (PLE) test and prone instability test (PIT). Thirty-three subjects (14 males, 19 females) with lower back pain enrolled in the study and the subjects were divided into 2 groups (positive and negative instability groups) on the basis of radiographies of flexion and extension. Reliability was determined by the kappa coefficient and validity was examined using calculated sensitivity, specificity, and the likelihood ratio. The results showed that the reliability of the PLE test was higher than the PIT (intra-rater reliability: k=.86 and k=.81, interrater reliability: k=.65 and k=.62) and the validity of the PLE test was also higher than the PIT (sensitivity: 91% and 62%, specificity: 95% and 85% positive likelihood ratio: 20.00 and 4.10, negative likelihood ratio: .10 and .45). In conclusion, we think that the PLE test was a more reliable and valid method for lumbar instability than the PIT.

The objective of this research was to examine the effects of lumber stabilization exercise and a general physiotherapy program for caregivers with chronic low back pain. Sixteen people participated in this study and were randomly assigned to two groups for either lumbar stabilization exercise or for general physiotherapy, respectively. The experiment was performed for eight weeks. To examine the general as well as the medical characteristics of the participants, the following measurements were used: Visual Analogue Scale (VAS); Oswestry Disability Index (ODI); Back Performance Scale (BPS); Roland - Morris Disability Questionnaire (RMDQ); and Beck Depression Index (BDI). To compare the general and medical characteristics of the participants in the two groups, an independent t test were used. During the experiment, a paired t test was conducted to determine whether there was a significant difference in the values of VAS, ODI, BPS, RMDQ, and BDI before and after the experiment. To examine the difference in the VAS, ODI, BPS, RMDQ, and BDI values in the two groups, ANCOVA was used with pre test values as a covariate. According to the test results, in the lumbar stabilization exercise group, the VAS, ODI, BPS, RMDQ, and BDI values showed a statistically significant difference before and after the test (p<.05). In comparison, in the general physiotherapy program group, only the ODI and BPS values showed a statistically significant level of improvement. Regarding the degree of improvement, participants in the lumbar stabilization exercise group showed statistically significant progress compared to those in the general physiotherapy group. In summary, lumbar stabilization exercise is regarded as more effective than general physiotherapy for treating caregivers with chronic low back pain. In future studies, it will be useful to expand the research and to examine the long term effects of lumbar stabilization exercise on workers.

The purpose of this study was to investigate the effects of meditation music with lumbar stabilization exercise on balance, concentration and muscle activation. Participants are divided into Group A and Group B. Group A listened to meditation music while doing 4 sets of lumbar stabilization exercise. Group B did not listen to meditation music while doing 4 sets of lumbar stabilization exercise. Surface EMG data was obtained rectus abdominis, external oblique, erector spinae, multifidus muscle during lumbar stabilization exercise. To examine the effect of before-after experiment for concentration and balance, paired t-test was adopted. Changes in EMG data of each muscles were analyzed by independence t-test. There were statistically significant increasing at concentration level and balance level in Group A. But significant difference was not shown in muscle activation. The clinical effect of the meditation music with lumbar stabilization exercise was investigated in this study with more excellent results in concentration and balance. In conclusion, these results suggest that meditation music and lumbar stabilization exercise may be useful in elderly people.