Background: For the elderly, masticatory function is one of the most important oral functions and the masticatory ability is related to the wearing of dentures. Many older people wear dentures for their masticatory function, but a significant number of older people who use dentures have found that they feel uncomfortable when performing their daily activities, such as performing masticating functions or talking. Objects: The purpose of this study is to investigate how the forward head posture (FHP), respiratory function and thickness of masseter (MS), and sternocleidomastoid (SCM) are affected by the presence or absence of dentures in the elderly, and what kind of correlation there is between these variables. Methods: The study was conducted on 11 patients in the normal group and 13 in the denture group. The participant’s cognitive ability was evaluated using Mini-Mental State Examination Korean (MMSE-K), and the FHP was evaluated by measuring the craniovertebral angle (CVA). The thickness of the MS and SCM muscles were measured using ultrasound, and respiration was measured with a spirometry. As for the statistical method, the correlation of each variable was investigated using Spearman’s correlation coefficient. Results: In the normal group, there was a significant correlation between forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) (p < 0.001), and in the denture group, FVC and FEV1 (p < 0.001), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (p < 0.001), CVA and Lt. MS (p = 0.012). Conclusion: CVA and Lt. MS of the denture group have a high negative correlation, it is related that the thickness of MS may be thick when the elderly wearing dentures are FHP.

Background: The craniocervical flexion test (CCFT) was developed for the activation and endurance of deep cervical flexors. However, the muscle thickness and muscle thickness changing ratio of the sternocleidomastoid (SCM) and deep cervical flexor (DCF) muscles in subjects with and without forward head posture (FHP) have not been reported. Objects: To determine the difference in thickness of the SCM and DCF muscles and the difference in the muscle thickness changing ratio between SCM, DCF, and DCF/SCM 20 mmHg and DCF/SCM 30 mmHg between subjects with and without FHP. Methods: Thirty subjects with and without FHP were enrolled. The muscle thickness of the SCM and DCF was measured when maintained at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg using a pressure biofeedback unit during the CCFT. Ultrasonography was used to capture images of SCM and DCF muscle thickness during the CCFT, which was calculated using the picture archiving and communication system (PACS). Results: We observed a significant difference within the pressure main effect between SCM and DCF at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg (p < 0.05). However, there was no significant difference in the muscle thickness and muscle thickness changing ratio for SCM and DCF during CCFT between subjects with and without FHP. Conclusion: There was no significant difference in the muscle thickness recruitment pattern during CCFT in posture changes between subjects with and without FHP.

Background: The superimposed technique (ST) involves the application of electrical muscle stimulation (EMS) during voluntary muscle action. The physiological effects attributed to each stimulus may be accumulated by the ST. Although various EMS devices for the quadriceps muscle are being marketed to the general public, there is still a lack of research on whether ST training can provide significant advantages for improving quadriceps muscle strength or thickness compared with EMS alone. Objective: To compare the effects of eight weeks of ST and EMS on the thicknesses of the rectus femoris (RF) and vastus intermedius (VI) muscles and knee extension strength. Methods: Thirty healthy subjects were recruited and randomly assigned to either the ST or EMS groups. The participants underwent ST or EMS training for eight weeks. In all participants, the thicknesses of the RF and VI muscles were measured before and after the 8-week intervention by ultrasonography, and quadriceps muscle strength was measured using the Smart KEMA tension sensor (KOREATECH Co., Ltd.). Results: There were significant differences in the pre- and post-intervention thicknesses of the RF and VI muscles as well as the quadriceps muscle strength in both groups (p < 0.05). RF thickness was significantly greater in the ST group (F = 4.294, p = 0.048), but there was no significant difference in VI thickness (F = 0.234, p = 0.632) or knee extension strength (F = 0.775, p = 0.386). Conclusion: EMS can be used to improve quadriceps muscle strength and RF and VI muscle thickness, and ST can be used to improve RF thickness in the context of athletic training and fitness.

Purpose: 본 연구의 목적은 4주기간동안 횡격막 호흡을 적용한 기구 필라테스 운동이 20대 성인의 유연성, 복부 근 두께, 근육량, 체지방, 호흡에 미치는 영향에 대해 알아보고자 하는 것이다. Methods: 근골격계 질환이 없는 대상자 35명을 대상으로 수행하였으며, 횡격막 호흡을 하는 그룹과 횡격막 호흡을 하지 않는 그룹으로 나누었으며, 두 그룹 모두 필라테스를 수행하였다. 실험에 사용한 기기로는 Ultrasonography(US), Pulmonary function tests(FEV1 / FVC), Bioeletic Impedance Analysis, Sit and reach test를 사용하였다. 정규성 검증을 실시한 후, 반복측정분산분석 (repeated measures of ANOVA)를 사용하여 운동 전, 호흡을 적용한 운동, 호흡 비적용 운동을 비교하였다. 사후 분석을 위해 Fisher’s LSD를 실시하였다. Results: 필라테스 운동은 복근의 두께와 유연성에 긍정적인 영향을 미쳤습니다. SaR test는 운동 전과 호흡을 적용한 운동과 호흡을 적용하지 않은 운동 사이에 유의한 유의성을 보였다(P <0.05). 근육두께 측정 TRA, EO, IO 모두 운동 전보다 호흡 적용 운동과 비호흡 운동에서 유의한 차이가 있었고(P <0.05), TRA와 IO에서는 추가 시간 사이에 유의한 차이가 없었다. 호흡하지 않는 운동(P >0.05). 그러나 EO에서는 호흡운동을 추가한 시간과 호흡운동을 하지 않은 시간 사이에 유의한 차이가 있었다( P <0.05). Conlusion: 결론적으로, 횡격막 호흡을 이용한 필라테스 운동과 횡격막 호흡이 없는 필라테스 운동은 복근의 두께와 유연성에 긍정적인 영향을 미치는 것으로 나타났다. 그러나 횡격막 호흡과 비횡격막 호흡 사이에는 큰 차이가 없었다.

Purpose: 본 연구의 목적은 본 연구의 목적은 2주간의 회전근개의 강화운동이 회전근개의 근육 두께, 견봉하 공간, 어깨 불안정성에 미치는 영향을 알아보고자 하는 것이다. Methods: 근골격계 질환이 없는 대상자 35명을 대상으로 수행하였으며, 횡격막 호흡을 하는 그룹과 횡격막 호흡을 하지 않는 그룹으로 나누었으며, 두 그룹 모두 필라테스를 수행하였다. 실험에 사용한 기기로는 Ultrasonography(US), Pulmonary function tests(FEV1 / FVC), Bioeletic Impedance Analysis, Sit and reach test를 사용하였다. 근골격계 질환이 없는 대상자 20명이 실험에 참여하였다. 근력 강화 운동은 2주 동안 주 5세트, 총 50세트 실시하였으며, 운동은 풀캔, 빈캔, 외회전 운동으로 진행하였다. 초음파를 이용하여 극상근과 극하근의 근육 두께와 견봉하 공간의 변화를 확인하였다. CSMI는 가시위근과 가시아래근의 근력을 평가하는 데 사용되었다. 정규성 검증을 실시한 후, 반복측정분산분석 (repeated measures of ANOVA)를 사용하여 운동 전, 1주후, 2주후를 비교하였다. 사후 분석을 위해 Fisher’s LSD를 실시하였다. Results: 근력의 비교에서 운동 2주 후 측정 시 내회전에서 유의한 차이가 있었다 (P <0.05). 외회전에서는 유의한 차이가 없었다 (P >0.05). 근육두께에서는 가시위근과 가시아래근의 근육 두께는 유의한 차이가 없었다 (P >0.05). 또한 봉우리밑 공간에서도 유의한 차이가 없었다 (P >0.05). Conlusion: 결론적으로, 빈캔 운동과 풀캔 운동, 측면 외회전 운동은 어깨관절 안쪽돌림의 근력 강화에 긍정적인 효과가 있었다

Background: Previous studies have been reported that when instrument assisted soft tissue mobilization (IASTM) and the self-myofascial release technique were used on the muscles. However, studies that applied the IASTM and self-stretching to the gastrocnemius muscle are thought to be necessary but there is no such previous study. Objectives: To investigate the effects of IASTM and self-stretching on gastrocnemius muscle thickness and the range of motion of joint in dorsiflexion in healthy college student. Design: Quasi-experimental design (single blind). Methods: The subjects were healthy college students in their 20s with a healthy body. As for the experimental method in this study, comparison between before and after the experiment was performed to compare the effects of myofascial release using IASTM and stretching. The preliminary survey investigated the range of motion (ROM) of ankle joint of the subjects. The thicknesses of gastrocnemius muscles were measured using ultrasonography. One day after the preliminary survey, IASTM interventions and self-stretching interventions were randomly selected. If IASTM intervention is selected, the IASTM of the gastrocnemius muscle was applied for 5 minutes. After than, muscle thickness and the ankle dorsiflexion ROM were measured. Subjects were asked to take a break for about one day after performing the intervention. Self-stretching was applied to the gastrocnemius muscle for 5 minutes identically. After than, muscle thickness and the ankle dorsiflexion ROM were measured. Results: The thickness of the gastrocnemius muscle decreased significantly IASTM intervention, and the ankle dorsiflexion ROM increased significantly IASTM intervention. Ankle dorsiflexion ROM increased significantly the selfstretching intervention. The amounts of change in ankle dorsiflexion ROM through the IASTM was significantly greater than that through self-stretching. Conclusion: In order to immediately increase muscle flexibility in a short time, the IASTM is more effective although the self-stretching method is also effective.

Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.

Background: Recently, a new method of dysphagia rehabilitation using Kinesio taping (KT) has been attempted and demonstrated an immediate increase in the activation of the suprahyoid muscle during swallowing in healthy adults. Objectives: To investigate the effect of dysphagia rehabilitation using KT on the thickness change of the suprahyoid muscle in patients with dysphagia after stroke. Design: Two-group pre-post design. Methods: In this study, 20 patients with dysphagia after stroke were enrolled and assigned to the experimental and control groups. The experimental group applied KT to the front of the neck and repeatedly swallowed against the tension of the tape. On the other hand, the control group performed repeated swallowing without applying KT. Patients in both groups had swallowed 50 times a day/5 times a week for 4 weeks. For evaluation, the volume of the geniohyoid, mylohyoid, and digastric muscle was measured before and after the intervention using portable ultrasound equipment. Results: As a result of comparing the two groups after the intervention, the experimental group showed more volume increase in mylohyoid (P<.05) and digastric muscle (P<.05) than the control group. Conclusion: This study proved that suprahyoid muscle resistance exercise using KT is effective in increasing the volume of the suprahyoid muscle.

Background: Bridging exercises are used to enhance the functional stability of the lumbopelvic region in clinical settings. Although most of the studies on bridging exercises have compared the complete activation of the trunk muscles, some recent studies have examined the functional stability of the trunk and the lumbopelvic region and assessed the appropriate recruitment of the local and global muscles during different task levels. Objects: The purpose of this study was to investigate the changes in muscle thickness in the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles during a common bridging exercise on an unstable surface and to determine whether these changes differ based on the surface used. Methods: Twenty-five healthy young adults (8 males, 17 females) were recruited. The subjects were randomly assigned to either the exercise progression with a sling bridge group or the ball bridging exercise progression group, each with three stages of increasing difficulty. Each position was measured three times with an ultrasonic diagnostic imaging system, and the mean values were recorded for analysis. Results: No significant differences were observed between the TrA, IO, or EO muscle thickness ratios between the sling and ball exercise groups (p > 0.05). There were also no significant differences in the EO muscle thickness ratios between the tasks irrespective of whether the sling or ball was used. However, the TrA and IO thickness ratios in both groups were significantly greater during stages 2 and 3 compared to stage 1. Conclusion: The results suggest that the use of slings and balls during bridging exercises is effective in activating the deep abdominal muscles.

Background: Whole body-electromyostimulation (WB-EMS) is widely used for the rehabilitation and recovery of patients with various neuromusculoskeletal disorders. Objects: To objectively measure changes in lower extremity and abdominal muscles after sit-to-stand dynamic movement training using WB-EMS. Methods: A total of 46 healthy adults (23 experimental and 23 control subjects) performed sit-to-stand exercise; the experimental group with WB-EMS, and the control group without WB-EMS. The muscle activity of the lower extremity, and the muscle thickness of the lower extremity and abdominal muscles were measured before and after the intervention. Results: In terms of electromyographic activity, there was a significant interaction effect for the rectus femoris (RF) muscle (F=30.212, p=.000). With regards to ultrasonographic imaging, the muscle thickness of the RF muscle had a significant interaction effect at the muscle contraction ratio (F=8.071, p=.007). The deep abdominal muscles, such as the transverse abdominal (TrA) and internal oblique (IO) muscles, also showed significant interaction effects at the muscle contraction ratio (F=5.474, p=.024, F=24.151, p=.000, respectively) Conclusion: These findings suggest that WB-EMS may help to improve the muscular activity of the RF muscle, and the muscle thickness of the RF muscle and deep muscles such as the TrA and IO muscles.

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, 24.0±5.0 years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.

Background: Functional ankle instability (FAI) indicating a decrease in muscle strength, proprioception, neuromuscular control, balance and postural control function. Objective: To investigate the effect of jumping exercise on the supporting surface on the ankle muscle thickness, proprioceptive sensation, and balance in adults with FAI. Design: Randomized Controlled Trial. Methods: Twenty young people with FAI were randomly assigned to the unstable supporting surface jump group (N=10) and the stable supporting surface jump group (N=10). The intervention was conducted three times a week for eight weeks, and for 30 minutes per session. Trampoline was used as an unstable support surface and the stable support surface was carried out on a regular floor. The thickness of the tibialis anterior muscle and medial gastrocnemius muscle was measured by ultrasonography, and the proprioception of dorsiflexion and plantarflexion was measured using an electrogoniometer. The dynamic balance was also measured with a balance meter. Results: The the muscle thickness of the medial gastrocnemius muscle was significantly higher in the stable supporting surface jump group than in the unstable supporting surface jump group (p<.05). Furthermore, the plantar flexion proprioception and dynamic balance were significantly improved in the unstable supporting surface jump group than in the stable supporting surface jump group in the intergroup comparison (p<.05). Conclusions: The conclusion has been reached in this study that the jumping exercise on the unstable supporting surface could be a more effective in improving FAI than the regular surface.

Background: Chronic low back pain (CLBP) causes morphological changes in muscles, reduces muscle strength, endurance and flexibility, negatively affects lumbar stability, and limits functional activity. Plank exercise strengthens core muscles, activates abdominal muscles, and improves intra-abdominal pressure to stabilize the trunk in patients with CLBP. Objects: We investigated the effect of plank exercise on abdominal muscle thickness and disability in patients with CLBP. Methods: We classified 33 subjects into 2 groups: An experimental (n1=17) and a control group (n2=16). Patients in the experimental group participated in plank exercise and those in the control group participated in stretching exercise. Patients in both groups attended 20-minute exercise sessions thrice a week for 4 weeks. Abdominal muscle thickness in each subject was evaluated ultrasonographically, and disabilities were assessed using the Oswestry disability index (ODI). Results: Four weeks later, abdominal muscle thickness showed a significant increase over baseline values in both groups (p<.05). Patients in the experimental group reported a more significant increase in the thickness of the external oblique muscle than that in the control group (p<.05). ODI scores in the experimental group were significantly lower after intervention than before intervention (p<.05). Conclusion: Plank exercise increases the thickness of the external oblique muscle and reduces disability secondary to mild CLBP. Therefore, plank exercise is needed to improve lumbar stability and functional activity in patients with mild CLBP.

Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group (n1=19) and a control group (n2=20). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

Background: The deep cervical flexor (DCF) muscles have a crucial role in the management of neck pain. For preventing neck pain by activation of the DCF, craniocervical flexion (CCF) is an effective exercise. However, sternocleidomastoid (SCM) muscle is considered to affect negatively the activation of the DCF. SCM muscle which is an accessory muscle for respiration is activated differently depending on types of breathing patterns. It’s not certain that breathing patterns affect the SCM and DCF muscles thickness during CCF exercise. Objects: The purpose of this study was to investigate the influence of breathing patterns on the SCM and DCF muscles thickness during CCF exercise. Methods: Forty-five subjects participated in this study, and they were classified according to their breathing pattern, as follows: Costodiaphragmatic breathing (CDB) and upper costal breathing (UCB) groups. Ultrasonographic imaging of the SCM and DCF muscles was performed during five incremental levels of CCF during tidal breathing and expiration. Results: There was a significant interaction between the breathing pattern and the phase of CCF for percentage of SCM muscle thickness changes (p˂.05). In phase 1 CCF, a percentage of SCM muscle thickness changes was increased in the UCB group than in the CDB group (p˂.05). There was an increase in DCF muscles thickness with each additional CCF phase (p˂.05). Conclusion: Recruitment of SCM muscle was increased in the UCB group while performing CCF with a low intensity. There were no significant differences on DCF recruitment between the breathing pattern groups. Higher CCF exercise intensities elicited a higher DCF recruitment.

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM (n1=10) and DBM (n2=9) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.

Background: A forward head posture (FHP) is one of the most common types of poor head posture in patients with neck disorder. A prolonged FHP might increase pressure on the posterior cranio-cervical structure and exhibit reduced performance on a cranio-cervical flexion test (CCFT). CCFT is included to activate deep cervical flexor muscles and inhibit excessive activation of superficial cervical flexor muscles. Therefore, the selective activation of deep cervical flexors is needed for effective exercise for FHP. Objects: The purpose of this study was to compare muscle thickness between longus colli (Lco) and sternocleidomastoid (SCM) using ultrasonography in subjects with FHP depending on head support. Methods: This was a cross-sectional, case-control research design study. The ultrasonographic images of Lco and SCM were taken in 17 subjects with FHP during the 5 phases of the CCFT with and without a head support. Towel was used for supporting head to make the neutral head position in supine. Changes in muscle thickness during the test were calculated to infer muscle activation. Data were analyzed using repeated measures of two-way analysis of variance with the significance level of .05. Results: When subjects performed the CCFT with head support, there was a significant difference in muscle thickness of Lco and SCM (p<.05). According to a post hoc paired t-test, change of thickness of Lco was greater at all phases, and change of thickness of SCM muscle was less at phase 4 and 5 in condition with head support (p<.01) compared to condition without head support (p<.01). Conclusion: The result of this study suggest that applying head support for neutral head position during CCFT could be a useful method for activating Lco muscle without excessive activation of SCM muscle.

The purpose of this study was to investigate the activity of the transverse abdominal muscle resulting from changed posture by measuring the thickness of the transverse abdominal muscle in a supine posture, a slouched sitting posture, and an erect sitting posture. The subjects of the study were 28 patients with cerebral palsy. All their transverse abdominal muscles at the end of inhalation were measured at supine, slouched sitting (S sitting) and erect sitting (E sitting) postures by using ultrasonography, and then their dynamic sitting balance was measured at S sitting and E sitting postures by using BioRescue. For the statistical analysis, the Kruskal-Wallis test and the Wilcoxon signed-rank test were used to compare the differences among each the postures. The results were as follows. The thickness of the transverse abdominal muscle when comparing the supine posture and the S sitting posture showed no statistically significant difference. But the E sitting posture showed a statistically significant difference as compared with the others. In addition, the dynamic sitting balance in comparing the S sitting and E sitting postures showed a significant difference. In conclusion, the E sitting posture has a more positive effect on postural control and balance than generally taking the S sitting posture, for the sitting posture of a patient with cerebral palsy. It is suggested that patients with cerebral palsy mainly experiencing a sedentary life or being in a wheelchair should be seated in the E sitting posture during their daily life, and it may be necessary to continue to monitor and manage the proper E sitting posture.

The purpose of the current study was to determine the intra- and inter-rater reliability of muscle thickness (MT) measurement of the psoas major (PM) using ultrasonography (US) conducted at different inward pressures of approximately .5 ㎏, 1.0 ㎏, 1.5 ㎏, and 2.0 ㎏. Twelve healthy male subjects were recruited for the study. The thicknesses of both PMs of each subject were measured by two different examiners in a random manner to assess the intra- and inter-rater reliability. The measurement values were analyzed using the intra-class correlation coefficient (ICC) with a 95% confidence interval (CI). ICC (2,1) was used to determine the inter-rater reliability and ICC (3,1) was used to assess the intra-rater reliability of the MT measurement of the PM. The results indicated higher ICC values for intra-rater reliability compared to inter-rater reliability. In addition, the value for intra-rater reliability with .5 ㎏ inward pressure [ICC=.99 (95%CI=.98∼.99)] was higher compared to 1.0 ㎏, 1.5 ㎏, and 2.0 ㎏. Other inward pressures for intra- and inter-rater reliability in current study were also demonstrated to have excellent values (ICC=.94∼.99). These findings showed that maintaining consistent inward pressure is essential for maintaining reliability of the results when the MT of the PM is measured by different examiners in a clinical setting.

The lower trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of ultrasound imaging to evaluate scapular muscle function warrants investigation. The purpose of this study is to use ultrasound imaging for determining the effectiveness of 4 different isometric exercises for maximally activating the lower trapezius muscles in healthy subjects. Twenty-eight (14 men and 14 women) volunteers were recruited for this study. Thickness measurements of the lower trapezius muscles were recorded during 4 exercises: latissimus pulldown (LP), prone V-raise (PV), prone row (PR), and modified prone cobra (MP). Lower trapezius muscle thickness was measured 3 times by 2 investigators at a point 3 cm lateral to the lateral edge of the T8 spinous process. The order of 4 exercise execution was randomized for each participant. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. Intraclass correlation coefficient (ICC) for intra-reliability was .86~.98 and inter-rater reliability .83~.96 for the lower trapezius, respectively (p<.01). Thickness changes in the lower trapezius muscles between the relaxed and contracted states in men were as follows: LP (, 182%), MP (, 167%), PV (, 149%), and PR (, 133%). In women the values were as follows: LP (, 163%), MP (, 131%), PV (, 129%), and PR ( mm, 100%). Thickness of the lower trapezius muscles significantly differed between exercises in both the gender (p<.01). The LP was the most effective exercise for increasing the activation of the lower trapezius muscle in both the gender. We recommend performing the LP exercise for strengthening the lower trapezius muscles.