The purpose of this study was to examine the effects of abdominal hollowing with ultrasound biofeedback on multifidus and transversus abdominis/internal oblique muscle activities during lifting tasks. This study recruited 12 healthy men. All subjects received training on expiration without and with abdominal hollowing with ultrasound biofeedback. After receiving training for each condition, the thickness of transversus abdominis was measured using ultrasound, and then, electromyography activities of transversus abdominis/internal oblique and multifidus during lifting tasks were measured using a surface electromyography system. The differences in thickness of transversus abdominis and electromyography activities of transversus abdominis/ internal oblique and multifidus between the two conditions were analyzed using paired t-test. Thickness of transversus abdominis and transversus abdominis/internal oblique and multifidus activities were significantly increased during expiration with abdominal hollowing with ultrasound biofeedback compared to during expiration without abdominal hollowing (p < 0.05). These findings suggest that abdominal hollowing with ultrasound biofeedback is effective in increasing trunk stabilizer muscle activities during both static and dynamic tasks such as lifting.

The purpose of this study was to investigate the effects of stable and unstable bridging exercises on the EMG activity of abdominal muscles. Twenty healthy women participated in this study and the muscle activities of left-right rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles were recorded during 4 bridging exercises (unilateral/ bilateral, stable/unstable). The activity of the right EO muscle was the highest during unilateral exercise in unstable condition, and left EO muscle also produced the same result. The activity of the right IO muscle was the highest during unilateral exercise in an unstable condition, and left IO muscle also produced the same result. The activity of the right RA muscle was the highest during unilateral exercise in a stable condition, and left RA muscle produced the same result. Unstable/unilateral (USUL) represented the highest activity among the 4 exercises. EO/IO muscles represented the highest activity during the USUL exercise, and RA did so during the stable/unilateral exercise. These results suggest that specific posture (USUL) can be administered targeting a specific side of abdominal muscles.

Background: Recently, there has been an emphasis on the use of interventions with biofeedback information for the maintenance or correction of posture. Objects: This study assessed the change of trunk posture and trunk muscle activation when people exhibiting postural kyphosis performed visual display terminal work with or without a contact feedback device (CFD). Methods: Eighteen right-handed individuals were recruited. Thoracic angle and right thoracic erector spinae (TES) muscle amplitude were analyzed. There were two sessions in these experiments. The control session involved 16 minutes of typing without a CFD, and the CFD session involved 16 minutes of typing with a CFD. The visual analog scale score was analyzed with a paired t-test, and the kinematic and electromyography data were analyzed through two-way repeated analysis of variance. Results: The paired t-tests revealed that subjects had significantly less pain after the CFD sessions than after the control sessions (p<.05). Significant main effects by session and by time were observed in the thoracic kyphosis angle (p<.05). There was a significant session×time interaction for TES amplitude (p<.05), along with significant main effects by session and by time (p<.05). Conclusion: The CFD caused people with postural kyphosis to straighten and to activate their TES continuously, even though they were habituated to bend their bodies forward. Therefore, the CFD was a beneficial treatment tool

Background: Prone hip extension (PHE) can be performed to measure the lumbopelvic motor patterns and motions. Imbalances in lumbopelvic muscle activity and muscle weakness can result in instability including pain in lumbopelvic region. The posterior oblique sling (POS) muscles contribute to dynamic lumbopelvic stability. In addition, POS are anatomically aligned with the trapezius muscle group according to shoulder positions. Objects: This study compared the electromyography (EMG) activity of POS and pelvic compensations during PHE with and without pre-activation of lower trapezius muscle (lowT). Methods: Sixteen healthy males were recruited. PHE was performed in randomized order: PHE with and without lowT pre-activation. Surface EMG signals were recorded for biceps femoris (BF), gluteus maximus (GM) (ipsilateral), lumbar multifidus (MF) (bilateral), and the lowT (contralateral). An electromagnetic tracking motion analysis was used to measure the angle of pelvic rotation and anterior tilting. Results: The ipsilateral GM and bilateral MF EMG amplitudes were greater during PHE with lowT pre-activation compared to PHE without lowT pre-activation (p<.05). The BF amplitude during PHE without lowT pre-activation was significantly greater than that during PHE with lowT pre-activation (p<.05). The angles of pelvic rotation and anterior tilting during PHE with lowT pre-activation were significantly smaller compared to PHE without lowT pre-activation (p<.05). Conclusion: PHE with lowT pre-activation, which is aligned with the POS, showed more increased MF and GM muscular activity with smaller lumbopelvic compensations in rotation and anterior tilting compared to PHE without lowT pre-activation.

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.

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 patellar height on quadriceps muscles' electromyography (EMG) activity during a squat exercise in adults with patella baja. For the study, we recruited 15 volunteers who had patella baja on the right side. We measured the EMG activity of the right rectus femoris, vastus medialis oblique, and vastus lateralis muscles during squat exercises under two conditions, specifically with and without an infra-patellar strap. The infra-patellar strap was applied below the tested patella to elevate the patella to a normal height. A paired t-test was used to compare the effects of patella height on EMG activity of the quadriceps muscles. The EMG activity of the rectus femoris (RF), vastus medialis oblique (VMO), and vastus lateralis (VL) muscles were significantly decreased during the squat exercise with the infra-patellar strap compared to the same exercise without the infra-patellar strap (p<.05), while the VMO/VL ratio was not different significantly between two conditions (p>.05). The findings of this study suggest that an infra-patellar strap may benefit people with patellar baja, as changes in patellar height could improve the efficiency of the quadriceps muscles.

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 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 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.

The purpose of this study was to compare EMG activity for pectoralis major muscle during shoulder movement with various abduction angle and rotation position in supine position. Fifteen healthy subjects were recruited for this study. All subjects performed shoulder horizontal adduction holding a 2 kg dumbbell in shoulder abduction 40˚, 70˚, 90˚, 130˚, 160˚ with shoulder neutral, internal rotation (IR), and external rotation (ER). Surface EMG activity was recorded from pectoralis major clavicle part and pectoralis major sternum part for 5 seconds and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). Dependent variables were examined with 3 (Neutral, IR, ER) 5 (40˚, 70˚, 90˚, 130˚, 160˚) analysis of variance with repeated measures. The EMG activity of pectoralis major muscle was significantly different between shoulder abduction angles and between shoulder rotation positions (p<.05). The highest value of EMG activity of pectoralis major clavicle part among shoulder abduction angles was in 70˚ and, 90˚ in that order. The highest value of EMG activity of pectoralis major sternum part among shoulder abduction angles was in and 130˚, 90˚ in that order. According to the rotation degree, shoulder ER showed the highest value and IR showed the lowest value in both muscle parts. These results suggest that shoulder abduction 70˚, 90˚, 130˚ will be effective during manual muscle testing (MMT) and strengthening exercise for pectoralis major muscle. It is also supposed that shoulder ER is the efficient posture for strengthening of pectoralis major muscle.

The purpose of this study was to compare visual analogue scale (VAS), pain threshold (PT), , and EMG gaps before and after applying transcutaneous electrical nerve stimulation (TENS) on the upper trapezius muscle at the patients with myofascial pain syndrome (MPS). The subjects were 4 men and 10 women composed of both the inpatients and outpatients who were diagnosed as MPS at Wonju Medical Center. VAS and PT measurements were performed to assess the subjective pain level. The reference voluntary contraction (RVC) test was performed for 15 seconds for normalization on the bilateral trapezius muscle using surface electromyography (sEMG). After 3-minute resting time, the EMG signal was recorded while performing a typing activity for 2 minutes and then TENS was applicated with a comfortable intensity for 10 minutes. The EMG activity of the upper trapezius muscle was recorded during typing for 2 minutes. The results of study were as follows: 1) VAS score was significantly decreased on the more painful side after treatment, however, it was not significantly different on the less painful side. 2) PT was increased after treatment on both sides, however, it was not significantly different between before and after the TENS application. 3) The EMG activity during typing was significantly decreased after treatment, and 4) The EMG gaps were significantly increased after TENS treatment compared to before it. Consequently, the study showed that TENS was effective in decreasing VAS, , and in increasing EMG gaps. The EMG gap analysis could be a useful method to measure pain in patients with MPS in the upper trapezius.

This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p>.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.