Effects of different core exercises on respiratory parameters and abdominal strength

[Purpose] This study determined the effects a new modality of core stabilization exercises based on diaphragmatic breathing on pulmonary function, abdominal fitness, and movement efficiency. [Subjects] Thirty-two physically active, healthy males were randomly assigned to an experimental group (n = 16) and a control group (n = 16). [Methods] The experimental group combined diaphragmatic breathing exercises with global stretching postures, and the control group performed common abdominal exercises (e.g., crunch, plank, sit-up), both for 15 minutes twice weekly for 6 weeks. Pulmonary function (measured by forced vital capacity, forced expiratory volume in 1 second, and peak expiratory flow) and abdominal fitness (measured with the American College of Sports Medicine curl-up [cadence] test and the Functional Movement Screen^TM) were evaluated before and after the intervention. [Results] Significant changes in curl-up (cadence) test scores, Functional Movement Screen scores, and all pulmonary parameters were recorded in the experimental group at the posttraining assessment, whereas in the control group, no significant differences over baseline were observed in any parameters. [Conclusion] Compared with traditional abdominal exercises, core stabilization exercises based on breathing and global stretching postures are more effective in improving pulmonary function and abdominal fitness.Key words: Respiratory parameters, Core stability, Diaphragmatic breathing     

A comparison of water-based and land-based core stability exercises in patients with lumbar disc herniation: a pilot study

Purpose: To determine and compare the effects of core stability exercise programs performed in two different environments in lumbar disc herniation (LDH) patients. Method: Thirty-one patients who were diagnosed with LDH and were experiencing pain or functional disability for at least 3 months were randomly divided into two groups as land-based exercises or water specific therapy. Also, 15 age–sex-matched healthy individuals were recruited as healthy controls. Both groups underwent an 8-week (3 times/week) core stabilization exercise program. Primary outcomes were pain, trunk muscle static endurance and perceived disability level. The secondary outcome was health-related quality of life. Results: Level of static endurance of trunk muscles was found to be lower in the patients compared to the controls at baseline (p?p?p?>?0.05). After the treatment, static endurance of trunk muscles of the LDH patients became similar to controls (p?>?0.05). Conclusion: According to these results, core stabilization exercise training performed on land or in water both could be beneficial in LDH patients and there is no difference between the environments.

• Implications for Rehabilitation

• An 8-week core stabilization program performed in water or on land decrease pain level and improve functional status in LDH patients.

• Both programs seem beneficial to increase health-related quality of life and static endurance of trunk muscles.

• Core stability exercises could be performed in water as well, no differences were found between methods due to environment.

     

The effects of core muscle release technique on lumbar spine deformation and low back pain

[Purpose] The purpose of this study was to examine the effects of the core muscle release technique on correction of lumbar deformation and alleviation of low back pain. [Subjects] Ninety patients diagnosed with lumbar deformation and low back pain participated in this study. [Methods] The participants were divided into three groups according to method of treatment. The first group was treated with the core muscle release technique (CRT), the second group was treated with general exercise, and the third group was treated with electrotherapy. The core muscle release technique group received 50-minute of the core muscle release technique 5 times a week for 2 weeks, and the participants in this group were instructed not to receive any other treatments. After the 2 weeks of treatment, the patients were reexamined. The general exercise group performed Williams flexion exercises and McKenzie extension exercises 5 times a week for 2 weeks. The electrotherapy group was treated by application of electrotherapy with an interferential current therapy machine (TM-301. TOPMED. Seongnam, Republic of Korea) to the abdominal muscles and back muscles of the lumbar region. [Results] The data suggest that the core muscle release technique, general exercise, and electrotherapy all helped to decrease the alignment angle and VAS score. Of these treatment methods, however, the core muscle release technique was the most effective for treatment of lumbar spine deformation and low back pain. [Conclusion] The core muscle release technique was most effective for correction of lumbar spine deformation and pain alleviation.Key words: Core muscle release technique, Lumbar spine deformation, Low back pain     

The effect of lumbar stabilization exercises and thoracic mobilization and exercises on chronic low back pain patients

[Purpose] To investigate whether pain, balance, and stabilization of the lumbar region can be improved through thoracic mobilization in addition to lumbar stabilizaing exercises. [Subjects and Methods] This study recruited 36 subjects with chronic low back pain lasting more than 12 weeks. The subjects recruited for this study participated voluntarily, and provided their signed consent to participation. [Results] Improvement in balance was largest in the lumbar stabilization exercise group, followed by the thoracic mobilization and exercise group, and the traditional physical therapy group, in decreasing order of effect. [Conclusion] In conclusion, lumbar stabilization exercises combined with thoracic mobilization had greater effects on stabilization of the lumbar region pain relief, and improvement of the function of the patients with chronic low back pain.Key words: Lumbar stabilization exercises, Thoracic mobilization exercises, Chronic low back pain     

The influences of position and forced respiratory maneuvers on spinal stability muscles

[Purpose] The purposes of this study were to investigate the influences of position on %MVIC of spinal stability muscles to establish for the most effective breathing pattern for activation of spinal stability muscles in order to provide an additional treatment method for use in spinal stability exercise programs. [Subjects and Methods] Thirty-three healthy subjects performed quiet breathing and four different forced respiratory maneuvers (FRM); [pursed lip breathing (PLB), diaphragmatic breathing (DB), combination breathing (CB) and respiration muscle endurance training (RMET)] in both standing and sitting positions. %MVIC of them (the multifidus (MF), erector spinae (ES), internal oblique/transversus abdominis (IO/TrA), external oblique (EO), rectus abdominis (RA) measured. [Results] IO/TrA, MF and EO showed greater activation in standing than in sitting, while RA and ES showed greater activation in sitting than in standing. RMET induced significantly greater activation of spinal stability muscles then other breathing patterns. %MVIC changes of muscle activities induced by FRM were independent of position with a few exceptions. [Conclusion] The increased respiratory demands of FRM induced greater activation of spinal stability muscles than QB. RMET was found to be the most effective breathing pattern for increasing the activation of the spinal stability muscles.Key words: Spinal stability muscles, Position, Forced respiratory maneuvers     

The effects of lumbar stabilization exercises on foot pressure of older individuals while walking

[Purpose] The purpose of this study was to examine the effect of lumbar stabilization on pressure distribution in old women. [Subjects] The subjects of this study were 14 women aged 65 or older who agreed to participate in this study. They had a sufficient range of motion and muscle strength to perform the postures in this study’s program and were without gait problems, congenital deformity, orthopedic disorder, or neurological disorder. [Methods] The participants performed a group exercise program that promotes lumbar stabilization for 50 minutes per session by following the instructions of a physical therapist. Gait Analyzer was used to measure the foot pressure of individual participants from three measurements for each lumbar stabilization exercise, and the mean values were used. The mean values were then compared between before and after the exercises by paired t-test. [Results] Pressure in F3 and F6 statistically significantly decreased from 2.06±1.23% N/cm² to 1.55±1.02% N/cm² and from 7.40±1.52% N/cm² to 5.95±1.76% N/cm², respectively, after the intervention, but no significant differences were found in the other foot areas. [Conclusion] The lumbar stabilization exercises affected the pressure evenly over the entire foot and, in particular, in the inner area of the forefoot.Key words: Lumbar stabilization exercise, Foot pressure, Gait Analyzer     

Effect of joint mobilization using KEOMT and PNF on a patient with CLBP and a lumbar transitional vertebra: a case study

[Purpose] The purpose of this case study was to identify the effects of joint mobilization using Kaltenborn-Evjenth orthopedic manual therapy (KEOMT) and proprioceptive neuromuscular facilitation (PNF) techniques on a patient with chronic low back pain (CLBP) and a lumbar transitional vertebra. [Methods] The intervention methods were joint mobilization using KEOMT and PNF techniques. The program consisted of 40-min sessions 3 days a week for 4 weeks. The spinal motion (thoracic and lumbar vertebrae), pain, and thickness of the multifidus were measured. [Results] The angle of spinal curvature increased, and the range of motions (ROMs) flexion and extension increased in the thoracic and lumbar vertebrae. The pain score as measured on a visual analogue scale (VAS) and the Oswestry disability index (ODI) score decreased. The thickness of the multifidus (L4) increased on the left and right sides. [Conclusion] These results suggest that joint mobilization using KEOMT and PNF techniques had a positive effect on the spinal motion, pain, and thickness of the multifidus of a patient with chronic low back pain and a lumbar transitional vertebra.Key words: Lumbar transitional vertebra, Joint mobilization, Proprioceptive neuromuscular facilitation     

The effect of core stability-based corrective exercises on gait parameters in elite soccer players diagnosed with Middle Crossed Syndrome

Background/aimsThe aim of this study was to investigate the effect of eight weeks of core stability-based corrective exercises, on gait parameters in elite soccer players diagnosed with middle crossed syndrome.Methods15 male elite soccer players (aged 18–28) were enrolled in a same-subject intervention trial to assess if the middle crossed syndrome could be influenced through core stability exercise. Core stability-based corrective exercises were completed 3 times per week for 8 weeks and changes in gait parameters (pre- and post- intervention) were measured.ResultsThe results showed that most gait parameters including stride length (p = 0.025), gait speed (p = 0.023), number of strides (p = 0.007), length of shots (p = 0.003), and also soccer players’ height (p = 0.011) improved significantly in post-intervention in comparison to pre-intervention. Stride width in post-intervention did not show changes in comparison with pre-intervention (p = 0.083).ConclusionThe results indicate the significant effectiveness of core stability-based corrective exercises on gait parameters in those with middle crossed syndrome. By doing corrective exercises based on core stability during the study period, gait parameters in the post-intervention surpass the results in the pre-intervention in most parameters. Therefore, it is proposed that corrective exercises based on core stability is a safe and useful method for improving function in those with middle crossed syndrome and it could be used as a therapy to help players identified with this finding. In this regard, it is suggested to researchers and coaches to correct imbalances in order to achieve better results in training programs.     

The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients

[Purpose] The aim of this study was to examine the effects of exercise to strengthen themuscles of the hip together with lumbar segmental stabilization exercise on the lumbardisability index, lumbar muscle strength, and balance. [Subjects and Methods] This studyrandomly and equally assigned 40 participants who provided written consent to participatein this study to a lumbar segmental stabilization exercise plus exercise to strengthen themuscles of the gluteus group (SMG + LES group) and a lumbar segmental stabilizationexercise group. [Results] Each evaluation item showed a statistically significant effect.[Conclusion] Clinical application of exercise in this study showed that lumbar segmentalstabilization exercise plus exercise to strengthen the muscles of the gluteus resulted ina greater decrease in low back pain disability index and increase in lumbar musclestrength and balance ability than lumbar segmental stabilization exercise in chronic lowback pain patients receiving the exercise treatments during the same period.     

Exertional rhabdomyolysis in unsupervised exercises in a correctional setting: a case study

Unsupervised overexercise in the prison population can lead to exertional rhabdomyolysis, a condition that can lead to kidney damage and/or failure. Knowledge deficit of the risk from this activity will be addressed. Signs and symptoms of rhabdomyolysis and its sequelae will be presented along with a case study. Inter-departmental responsibilities in the correctional setting will be considered. The importance of recognizing the signs and symptoms of this condition by nurses in various clinical settings will also be explored.     

Impact of decline-board squat exercises and knee joint angles on the muscle activity of the lower limbs

[Purpose] This study aims to investigate how squat exercises on a decline board and how the knee joint angles affect the muscle activity of the lower limbs. [Subjects] The subjects were 26 normal adults. [Methods] A Tumble Forms wedge device was used as the decline board, and the knee joint angles were measured with a goniometer. To examine the muscle activity of the biceps femoris, rectus femoris, gastrocnemius lateralis, and tibialis anterior of the lower limbs, a comparison analysis with electromyography was conducted. [Results] The muscle activity of the biceps femoris, rectus femoris, gastrocnemius lateralis, and tibialis anterior increased with increased knee joint angles, both for squat exercises on the decline board and on a flat floor. When the knee joint angle was 45°, 60°, and 90°, the muscle activity of the rectus femoris was significantly higher and that of the tibialis anterior was significantly lower during squat exercises on the decline board than on the flat floor. When the knee joint angle was 90°, the muscle activity of the gastrocnemius lateralis was significantly lower. [Conclusion] Squat exercises on a decline board are an effective intervention to increase the muscle activity of the rectus femoris with increased knee joint angles.Key words: Decline board, Squat exercise, Range of motion     

Impact of the clinical Pilates exercises and verbal education on exercise beliefs and psychosocial factors in healthy women

[Purpose] Exercise is one of the most important components of a healthy life. The purpose of this study was to analyze exercise beliefs and psychosocial factors in sedentary and active healthy women and observe the changes in these parameters resulting from clinical Pilates exercises and verbal education in healthy women. [Subjects and Methods] Sixty-six healthy women were included in the study. Participants were divided into clinical Pilates (n=21), verbal education (n=25), and control groups (n=20). Prior to and at the end of the study, demographic information, body mass index, waist-hip circumference, exercise beliefs, physical activity index, and psychosocial factors (Rosenberg self-esteem scale, Body Cathexis Index, SF-36 quality of life, Beck Depression Scale, visual analog scale for tiredness) of the subjects were recorded. [Results] Meaningful changes for all the parameters took place in the clinical Pilates and verbal education groups. Our analyses indicated that the changes in the clinical Pilates group were more meaningful than those in the verbal education group. When the data of the study groups were compared with those of the control group, the clinical Pilates group showed meaningful differences. [Conclusion] The result of this study indicate that both clinical Pilates and verbal education are effective in changing exercise beliefs and physical and psychosocial parameters.Key words: Theory of planned behavior, Exercise beliefs, Pilates     

Effects of modified bridging exercises on static postural control of a poststroke hemiplegic patient who had received surgery for lumbar spinal stenosis: a case report

[Purpose] This study investigated the efficacy on postural control of a bridging exercise in order to suggest a pertinent procedure for the bridging exercise. [Subject] One poststroke hemiplegic patient who had received surgery for lumbar spinal stenosis participated in this study [Methods] A reverse ABAB single-case experimental design was used. To assess postural control, foot pressure and the stability limit test were evalulated once a week a total of 4 times during the intervention period. [Results] Noticeable improvement in the distribution of foot pressure and increased stability limit were shown after performing the bridging exercise supervised by a physical therapist. [Conclusion] Bridging exercise on a plinth is effective at balancing body weight-bearing and resulted in the patient putting her weight on both feet evenly and in both the anterior and posterior directions.Key words: Bridging exercise, Hemiplegia, Postural control     

Effect of exercise on the expression of nerve growth factor in the spinal cord of rats with induced osteoarthritis

[Purpose] We examined the impact of exercise on the expression pattern of nerve growth factor in the spinal cord of rats with induced osteoarthritis of the knee joint. [Subjects and Methods] To produce monosodium iodoacetate-induced arthritis, rats were administered 3 mg/50 µL monosodium iodoacetate through the interarticular space of the right knee. The animals were randomly divided into four groups: rats sacrificed 3 weeks after 0.9% saline solution injection (shame group, n = 10), rats sacrificed 3 weeks after monosodium iodoacetate injection (control group, n = 10), rats with 4 weeks rest from 3 weeks after monosodium iodoacetate injection (no exercise group, n = 10), and rats with 4 weeks treadmill training from 3 weeks after monosodium iodoacetate injection (exercise group, n = 10). Serial coronal sections of the lumbar spine were cut and processed for immunohistochemistry. [Results] The expression of nerve growth factor was significantly increased in the EG compared with the SG, CG, and NEG. [Conclusion] Increased nerve growth factor expression in the spinal cord due to exercise-induced stimulation can be effective in treating chronic pain. Such treatment will contribute not only to improving the joint function of patients with chronic pain but also their quality of life.Key words: Osteoarthritis, Treadmill exercise, Nerve growth factor     

Spondylolisthesis on bilateral pedicle stress fracture in the lumbar spine: a case study

We report the clinical case of a 54-year-old woman presenting radicular low back pain on the right side of L4 associated to spondylolisthesis on L4-L5, without any notion of trauma or spine surgery. Furthermore this patient is regularly seen for benign rheumatoid polyarthritis complicated by steroid-induced osteoporosis. A preventive treatment was implanted with good results on pain improvement and functional capacities. For pedicle fractures the literature review reports several different etiologies: spontaneous fractures, hereditary fractures or stress-related fractures. There was a discussion on the various treatments available and in this case of spondylolisthesis on pedicle fracture a conservative treatment was implemented similar to the one for isthmic spondylolisthesis. It yielded satisfying results.     

Spontaneous regression of a large sequestered lumbar disc herniation: a case report and literature review

Lumbar disc herniation is a common disorder in adults that is accompanied by lower back and radicular pain. A 32-year-old man visited our clinic with 1-week history of persistent lower back pain and weakness in his right big toe. Magnetic resonance imaging (MRI) of his lumbar spine revealed herniated discs at L3/L4, L5/S1 and L4/L5, where a right-sided intraspinal mass lesion deep to the L4 vertebral body was causing compression of the nerve root. The patient underwent conservative treatment and reported no symptoms referrable to his back or leg 4 months later. Follow-up MRI showed no herniation of the nucleus pulposus at the L4/L5 level or lesion deep to the vertebral body of L4, whereas no changes had occurred to the status of the herniated L3/L4 and L5/S1 discs. The present case and a literature review show that a sequestered lumbar disc herniation can regress within a relatively short timeframe without surgery. The authors emphasise the utility of conservative therapy for patients who do not have a definitive surgical indication.     

The effects of isometric trunk exercises and dynamic trunk exercises on gait in elderly people

The purpose of this study was to compare the effects of dynamic trunk exercises and isometric trunk exercises on gait in elderly people. [Subjects] This study randomly allocated 20 elderly people to an isometric trunk exercise group (n=10) and a dynamic trunk exercise group (n=10). The exercises were performed for 30 minutes three times a week for 12 weeks. Gait speed, stride length, cadence, and step width were measured at a normal pace using GAITRite. All groups were evaluated before and after 12 weeks. [Results] The isometric exercise group showed a significant change in gait velocity, cadence, and left and right step lengths. The dynamic trunk exercise group showed a significant change in gait velocity, cadence, left and right step lengths, left and right step times, and left and right stride lengths. Moreover, a comparison of the exercise effect between the two groups showed a significant difference in gait velocity. [Conclusion] The results of this study suggest that isometric trunk exercises and dynamic trunk exercises have a positive effect on gait function in elderly people. In particular, isometric trunk exercises are recommended to promote gait velocity.Key words: Isometric trunk exercise, Dynamic trunk exercise, Gait     

Successful treatment of continuous ossification of the posterior longitudinal ligament in the lumbar spine using percutaneous transforaminal endoscopic spinal decompression: a case report

Ossification of the posterior longitudinal ligament (OPLL) of the lumbar spine is rare relative to that of the cervical spine but is often associated with more severe symptoms. Continuous lumbar OPLL is extremely rare. We herein describe a 48-year-old Chinese woman with lumbar spinal stenosis caused by continuous OPLL. She presented with a 5-year history of lower back pain and intermittent claudication. We performed percutaneous transforaminal endoscopic decompression by the posterolateral approach to achieve adequate decompression of the spinal canal up to the lower 1/3 level (0.9 cm) of the L1 vertebral body and down to the upper 1/2 level (1.3 cm) of the L2 vertebral body. After surgery, the patient’s neurological function substantially improved, and her visual analog scale scores for the lower back and both lower extremities and her Oswestry disability index were significantly lower than those in the preoperative period. During the 12-month clinical follow-up period, the patient’s neurological function was fully restored, and she regained her ability to walk normally. No surgery-related complications were observed. This case report describes a novel surgical approach that may be an effective treatment alternative for continuous lumbar OPLL.     

Balance in focus: a simple observational scale to monitor the effect of exercises on static balance in case of childhood flexible flat foot

[Purpose] Childhood flexible flat foot is the most common lower limb deformity. Observational evaluation of the underlying elements of reactive balance during static positions is an accepted tool besides the timed measures. We aim to assess the effects of combined balance training on the foot function and to test the usefulness of our observational static balance score. [Participants and Methods] A total of 19 healthy primary school students with flexible flat foot deformity volunteered for the study. We evaluated the foot’s dynamic properties and static postural stability before and after a 20-week combined balance training. On the basis of the observational findings, the time vs. quality observational static balance score was developed. All data were subjected to Wilcoxon’s test and Friedman’s ANOVA to compare the effects of the training on foot trajectory and observational static balance score. [Results] Better strength and endurance in the foot extensors and improved foot function were noted after the training. Using our observational static balance score, the quality of the balance performance remarkably changed. [Conclusion] The quality domain of our new scale seems to be a useful tool in daily clinical practice and a more sensitive measure in eyes-closed situations.Key words: Balance, Foot, Movement strategy     

Association between handgrip strength and cognitive impairment in elderly Koreans: a population-based cross-sectional study

[Purpose] The purpose of this study was to investigate the association between handgrip strength and mild cognitive impairment in elderly adults. [Subjects] Study participants included 2,982 adults (1,366 males and 1,616 females), aged 65 years or older. [Methods] This population-based cross-sectional study used the baseline database from the Korean Longitudinal Study of Ageing. [Results] The odds ratio for mild cognitive impairment showed a significant linear decrease in relation to the quartile of handgrip strength, independent of potential covariates, in both men and women. Moreover, after excluding incident cases of mild cognitive impairment, the results showed that greater handgrip strength was associated with higher cognitive function scores in the elderly. [Conclusion] The findings presented here suggest that handgrip strength is associated with a risk of mild cognitive impairment in the Korean elderly. Moreover, greater handgrip strength is associated with higher cognitive function in cognitively normal elderly individuals.Key words: Handgrip strength, Cognitive function, Elderly