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1 1) 스위스볼을적용한교각자세변화에따른체간의근활성도비교 The Comparison of Trunk Muscles Activity During Bridging Stabilization Exercises on Swiss Ball According to Change of Position Sun-tae Son, Min-hye Kim, Hee-jin Kim, Ji-hye Yoon, Su-kyung Lee, Ju-young Jung, Sung-soo Bae Department of Physical Therapy College of Rehabilitation Science, Daegu University <Abstract> Purpose : The purpose of this study was to assess the effect of bridging stabilization exercises of trunk muscles activity on a Swiss ball according to change of position. Methods 30 healthy university students volunteered to participate in this study. Subjects were required to complete following three exercise positions. Exercise position 1; Supine bridge with Swiss ball, Exercise position 2; Side bridge with Swiss ball, Exercise position 3; Prone bridge with Swiss ball. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. Results : A repeated measures of ANOVA with Duncan's correction was used to determine the influence of exercise type on muscle activity for rectus abdominis, external oblique, erector spinae. The erector spinae of exercise position 1 showed significantly higher muscle activity than exercise position 2, 3(p<.05). The external oblique of exercise position 2, 3 showed significantly higher muscle activity than exercise position 1(p<.05). The rectus abdominis of exercise position 3 showed significantly higher muscle activity than exercise position 1, 2(p<.05) Conclusion These results indicate that muscle activity can be influenced by addition of a Swiss ball in bridging exercises. It is recommend to use a Swiss ball for trunk stabilization exercise. Key Words Position, Bridging stabilization exercise, Electromyography, Trunk muscle Ⅰ., ssbae@daegu.ac.kr / /

2 80%, O'Sullivan (2003), (reposition sense)..(, 2001) Arokoski (2001) 1937 williams,,,,,,. (bridging exercise).,.(stevens, 2007). (lumbar stabilization). (2004),.,., (Maffey-ward, 1996). (2000),,,,. Marshall (2005). (mobility) (stretching), -,,,.., (, 2004)., (, 2001).,,. (McGill et al. 2003). ( 2007).,, (Hall Brody, 1999; Neumann, 2002).,

, ( 2004). (Richardson 2002).... (Richardson 2002). (global muscle) (local muscle).. (intrinsic muscle) (Bergmark 1989). (Marshall, Murphy 2005; Stevens 2007). 20,,.,. 15, 15. Table 1.

3 , ( 2004). (Richardson 2002).... (Richardson 2002). (global muscle) (local muscle).. (intrinsic muscle) (Bergmark 1989). (Marshall, Murphy 2005; Stevens 2007). 20,,.,. 15, 15. Table 1. Characteristics of subjects(man) characteristic average± standard deviation range age(years) (n=15) Height(cm) Body weight(kg) Table 2. Characteristics of subjects(woman) (n=15) characteristic average± standard deviation range age(years) 23 ± Height(cm) ± Body weight(kg) 50.2 ± (surface EMG) BioGraph Infiniti TM (Thought Technology Ltd, Canada) (Fig 1).,, 3 3 Ⅱ , 6 Fig 1. Surface EMG, BioGraph Infiniti TM (Thought Technology Ltd, Canada)

.. (1) (rectus abdominis) : 2cm. (2) (external oblique) : 15cm.

20~500Hz 3 14 - (14 Bit Analog-Digital converter), TT-USB. 20 5 10.

Daniels Worthingham (Hislop, 1995). %MVIC.. 0 (Fig 2-1). (2) 2.

4 .. (1) (rectus abdominis) : 2cm. (2) (external oblique) : 15cm. (3) (erector spine) : L4 2cm. 20~500Hz (14 Bit Analog-Digital converter), TT-USB root mean square(rms). 3 RMS. 5 2, 1 3. Daniels Worthingham (Hislop, 1995). %MVIC.. 0 (Fig 2-1). (2) 2.. (Fig 2-2). Fig 2-2. Exercise position 2 (3) 3 (Fig 2-3) (1) 1 15 Fig 2-3. Exercise position 3 Fig 2-1. Exercise position Table 2.

5 Table 2. Swissball size Height (cm/inch) Ball Size (cm/inch) Ball Color 140~150 / 55~66 45 / 17.7 yellow 155~165 / 61~66 55 / 21.6 red 170~180 / 67~71 65 / 25.6 green 183~190 / 72~75 77 / 29.5 blue 190 / / 33.5 white Table 3. Comparison of one-way ANOVA test according to movement method with activities of trunk muscles (%MVIC) 1. (%MVIC) (%MVIC) Table 3.,, (p<.05) , 2 3 (p<.05). RF EO ES Movement RF : Rectus femoris EO : External oblique ES : Erector spinae 4. average± standard deviation ± ± ± ± ± ± ± ± ±10.08 F p * * * Table 4. Comparison of movement method with activities of trunk muscles RF Average difference(i-j) Standard error * * * * EO Average difference(i-j) Standard error * * * * * * ES Average difference(i-j) Standard error * * * * p p p SPSS 12.0., (repeated one-way ANOVA). Duncan's correction. α=.05. Ⅲ.

6 Fig 3. Comparison of movement method with activities of trunk muscles(*p<.05) 1 2 (p<.05). 1 3 (p<.05) (Table 4, Fig3). Ⅳ.,, (stevens, 2006),,,,,, thoracolumbar fascia(tfl) (Nouwen et al, 1987)., (Akuthota Nadler, 2004)., (Lehman, 2005). -,.. Vera-Garcia (2000),.,,.,,.,., , , 3.

7 1 2, 3, (co-contraction) (, 1997; Shumway -Cook Woollacotte, 1995).. (Hall Brody, 1999; Neumann, 2002). (, 1996; Shumway-Cook Woollacotte, 1995).. (Shumway-Cook Woollacotte, 1995)... (Shumway-Cook Woollacotte, 1995)..., (multifidus) (trans-verse abdominal) (fine-wire),.... Ⅴ.,,

8 ,, ;17(1): ;16(1): (Moire) ;21(4):30-1.,. (Swiss ball) ;42(2): ,,. Hook-lying ; 13(3): Physioball Floor ,, ; 4(3): (Swiss Ball) (Sling),, ;13(2):61-4.,, ; 16(1):2-6., ;16(1): ,, ;3(3):82-91.,,.,. 2006;17 (6): ,,. (Swiss ball) 6,, ;13(1): Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):S86-92 Arokoski JP, Valta T, Airaksinen O, et al. Back and abdominal muscle function during stabilization exercise. Arch Phys Med Rahabil. 2001:82: Bergmark A. Stability of the Lumbar Spine. A study in mechanical engineering. Acta Orthopaedica Scandinavica Supplementum. 1989;23(6) Gary M., Souza., Electro myographic activity of Selected trunk muscles during dynamic spine stabilization exercises. Arch Phys Med Rehabil. 2002;82: Hall CM, Brody LT. Therapeutic Exercise: Moving toward Function. 1st ed. Philadelphia, Lippincott Williams and Wilkins Lehman GJ, Hoda W, Oliver S. Trunk muscle activity during bridging exercises on and off a Swissball. Chiropa & Osteopat. 2005;30:13-4. Maffey-Ward L, Jull G, Wellington L. Toward a clinical test of lumbar spine kinesthesia. J Orthop Sports Phys Ther. 1996;24(6): Marshall PW, Murhpy BA. Core stability exercises on and off a Swiss ball. Arch Phys Med Rehabil. 2005;86(2): McGill SM, Grenier S, Kavcic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol.

9 2003:13(4): Neumann DA. Kinesiology of the Musculo-skeletal System: Foundations for physical rehabilitation. Mosby, Nouwen. A. Patterns of muscular activity during movement impatients with chronic low back pain. Spine. 1987;12: O'sullivan PB, Burnett A, Floyd AN, et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28(10): Richardson CA, Snijders CJ, Hides JA, et al. The relation between the transversus abdominus muscle, sacroiliac joint mechanics, and low back pain. Spine. 2002;27: Shumway-Cook A. Woollacott MH. Motor control: Theory and practical applications. 1st ed. Baltimore: Lippincott Williams and Wilkins, 1995 Souza GM, Baker LL. Powers CM. Electromyo- graphic activity of selected trunk muscle during spine stabilization exercises. Arch Phys Med Rehabil. 2001;82(11): Stevens VK, Bouche KG, Mahieu NN, et al. Trunk muscle activity in healthy subjects during bridging stabilization exercise. BMC Musculoskelet Disord. 2006;7:75. Stevens VK, Coorevits PL, Bouche KG, et al. The influence of specific training on trunk muscle recruitment patterns in healthy subjects during stabilization exercises. Man Ther. 2007:12(3): Stevens VK, Bouche KG, Mahieu NN et al. Trunk muscle activity in healthy subjects during bridging stabilization exercise Vera-Garcia FJ, Grenier SG, Mc Gill SM. Abdominal muscle response during curl-ups on both stable and labile surfaces, Phys Ther. 2000; 80(6):564-9.

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar