Background: Although various exercises have been performed for patients with chronic low back pain (CLBP), the effects of these exercises including joint mobilization, gym ball exercises, and breathing exercises on flexion relaxation ratio (FRR) have not been compared. Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on the flexion relaxation phenomenon (FRP) and pain in patients with chronic low back pain. Design: Randomized pretest-posttest control group design. Methods: Thirty-six patients with chronic low back pain who were undergoing rehabilitation at a rehabilitation center were included. The patients were randomly divided into three groups: joint mobilization group (JMG; n=12), gym ball exercise group (GBG; n=12), and breathing exercise group (BEG; n=12). The exercises were performed for 40 minutes a day, twice a week, for a total of 12 weeks. Results: There were no significant differences in FRR between the three groups (P>.05). Significant decreases in the modified visual analog scale (MVAS) scores after intervention between the groups were found (P<.05). The GBG was significantly decreases from the JMG in the MVAS (P<.05). However, there were significant improvements between the pre- and post-interventional findings on FRR and MVAS in the three groups (P<.05). Conclusion: We demonstrated that intervention using joint mobilization, gym ball exercises, and breathing exercises improve FRP and pain in patients with CLBP.

Background: Squatting is one of the best functional exercises to strengthen the quadriceps muscle in independent gait and activities of daily living. Although the use of a gym ball during squat exercise is the most common way of strengthening the vastus medialis oblique (VMO) muscle, published data on this subject are limited. Objects: The purpose of this study was to compare the sequential muscle activation of the VMO and vastus lateralis (VL) muscles during squat exercise using a gym ball at different knee flexion angles. Methods: Forty healthy adults were randomly divided into experimental (squat exercise using a gym ball) and control (squat exercise alone) groups, in which squats were performed at 45° and 90° knee flexion. Electromyographic (EMG) activity data were collected over 10 seconds under the 2 angles of knee flexion (45° and 90°). Results: There was significant group and time interaction effect for VMO and VL muscle activation at 45° knee flexion. This was similarly demonstrated at 90° knee flexion. No significant group main effect and time main effect for VMO and VL muscle activation were noted at 45° knee flexion, respectively. In contrast, there was significant group main effect and time main effect for VMO and VL muscle activation at 90° knee flexion. These significant differences were demonstrated through two-way analysis of variance over repeated measurements, suggesting that the EMG activity of the VMO muscle during squatting with a gym ball showed remarkable improvement compared to that of the VL muscle. Conclusion: This research suggests that squat exercise using a gym ball may be more beneficial in improving the activity of VMO than of the VL muscle at both 45° and 90° of knee flexion, respectively. We highly recommend squat exercises with a gym ball for selective strengthening of the VMO muscle in knee rehabilitation.

The use of a gym ball is becoming more popular for dynamic balance exercises. However, little is known about the effects of the dynamic ball exercises in the elderly. The purpose of this study was to compare balance and functional mobility after dynamic balance exercises using a gym ball to reduce the risk factorfor falls. All of the 15 subjects were women between the ages of 68 and 91 (mean age=79.9 yrs, SD=5.87) at anursing home in Wonju. Seven of fifteen subjects were placed in the experimental group and the others in the control group. Three clinical tests were used to determine the degree of balance and functional mobility before beginning the exercise program, after 4 weeks of gym ball exercise, and after 8 weeks of gym ball exercise. These three tests included Timed Up & Go (TUG), Berg Balance Scale (BBS) and the Functional Independence Measure (FIM). Dynamic ball exercises training for 8 weeks (5 days per week) included side stretching, prone walking, bridging, marching and opposite arm and leg lifting. There were significant differences found before the gym ball exercise program began and after 4 weeks and then 8 weeks in the experimental group (p<.05). Significant differences between the groups were shown for TUG and BBS (p<.05). No significant difference was noted between the groups for FIM. Therefore, gym ball exercises can improve dynamic balance and may be recommended to include in a therapeutic program to help the elderly reduce their risk of a fall.