• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.71-75
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• 2013

Purpose: Although use of a tilt table is recommended in clinical practice, there are no published guidelines regarding pressure and inclination for tilt table use. The aim of the current study was to assess the changes of pressure on sacrum and buttock according to different inclination of the tilt table in healthy subjects. Methods: Thirty two healthy subjects participated in this study. Subjects were positioned supine on the tilt table and safety straps were secured across the chest, pelvic, and knee with sufficient tension to prevent the subjects from falling. Pressure and peak pressure of sacrum and buttock were measured using pressure mapping system with the tilt table standing at $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $75^{\circ}$, and $85^{\circ}$ inclination. Results: A significant decrease in the pressure of sacrum and buttock was achieved by increasing tilt table inclination (p<0.05): $0^{\circ}{\sim}15^{\circ}$ (8.16%), $15^{\circ}{\sim}30^{\circ}$ (8.02%), $30^{\circ}{\sim}45^{\circ}$ (11.61%), $45^{\circ}{\sim}60^{\circ}$ (16.18%), $60^{\circ}{\sim}75^{\circ}$ (16%), and $75^{\circ}{\sim}85^{\circ}$ (11.48%). A significant decrease in the peak pressure was achieved by increasing tilt table inclination (p<0.05): $30^{\circ}{\sim}45^{\circ}$ (9.91%), $45^{\circ}{\sim}60^{\circ}$ (19.24%), $60^{\circ}{\sim}75^{\circ}$ (19.93%), and $75^{\circ}{\sim}85^{\circ}$ (11.48%). No significant peak pressure change was observed in $0^{\circ}{\sim}15^{\circ}$, $15^{\circ}{\sim}30^{\circ}$ tilt table inclination (p>0.05). Conclusion: The results of this study showed that the pressure of sacrum and buttock were decreased according to increasing tilt table inclination in healthy subjects. Guidelines are needed in order to optimize patient safety and overall outcome for tilt table standing.

• Proceedings of the Korean Operations and Management Science Society Conference
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• 1995.04a
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• pp.529-533
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• 1995

안장은 인체하중이 집중되고, 자전거의 충격과 진동이 직접 전달되는 부위로서 주행 안락도를 높이고 buttock의 discomfort를 감소시킬 수 있도록 설계되어야 한다. 본 연구의 목적은 인체곡면을 본뜬 안장형상 설계를 통하여 buttock의 국부적 discomfort를 감소시키고자 하는 것이다. 인간의 앉은자세에 대한 해부학적 고찰을 통해 좌골결절(Ischial Tuberosity)과 치골결합면(Symphyseal Surface)이 안장과 직접 맞닿는 면으로 파악되었으며, 이들 부위에 대한 집중적 개선이 이루어져야 할 것으로 제안되었다. 문헌조사를 통해 의자설계시 고려해야 할 인체치수 및 지침을 파악하였으며, 안장과 의자의 기능비교를 통해 이를 선별적으로 적용하였다. 인체곡면 측정을 위해 Rod Matrix(3cm 간격, 13*20)방법을 이용하여 10명의 buttock contour를 측정하였으며, 측정된 자료를 분석하여 안장의 곡면형상을 결정하였다. General Comfort Rating, Body Part Discomfort 등의 주관적 안락도 평가방법을 통하여 기존 자전거 안장과 본 연구를 통해 개발된 안장을 비교 평가한 결과, 전반적인 안락도의 향상과 좌골결절 및 치골 결합부의 discomfort 감소효과를 가져온 것으로 파악되었다.

• Physical Therapy Korea
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• v.24 no.2
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• pp.66-75
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• 2017

Background: After a stroke, the control of the trunk muscle may be severely impaired. Due to the importance of trunk control in complex daily postures, the ability to adopt a correct sitting posture is considered a determinant of the recovery of independent function after a stroke. Objects: The purposes of this study were to compare differences in buttock pressure between the left and right sides of hemiplegic patients and differences in their pelvic tilting angles (sagittal and coronal planes) after sitting training with visual biofeedback (VBF) in real time. Methods: Twenty-two individuals with unilateral strokes (11 left-side and 11 right-side hemiplegic stroke patients) participated in this study. Buttock pressure was measured using a pressure mat, and pelvic angles were measured using a palpation meter. Results: The asymmetry of pressure between the right and left (first and third chamber) sides was significantly decreased after the VBF training. The measurements obtained using the palpation meter revealed a significant decrease in the pelvic angles pre- versus post-intervention. Conclusion: VBF training may be distribute a patient's buttock pressure equally while in a sitting posture and increase the length of time a stroke patient can maintain a symmetrical sitting posture. It can also improve pelvic control while sitting in a neutral position.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.229-232
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• 2008

Insufficiency fractures of the sacrum are relatively common and cause severe low back and buttock pain. Percutaneous vertebroplasty is effective for treating vertebral compression fractures. We present a case of percutaneous sacroplasty for the treatment of low back and buttock pain in a sacral insufficiency fracture. A 79-year-old male with non-small lung cancer presented with severe low back and buttock pain after series of radiation treatments. Preoperative MRI showed both a sacral ala and S2 metastatic insufficiency fracture. An epidural port was inserted for continuous morphine infusion and sacral nerve root blocks were performed. However, his pain did not diminish and we attempted percutaneous sacroplasty. Both sides of the sacroplasty were done with a fluoroscopy-guided technique with 1.7 ml and 2.3 ml of bone cement injected into the right and left sacral ala. Pain relief was significant and the patient was able to sit down 1 day after the procedure.

• Physical Therapy Korea
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• v.21 no.1
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• pp.37-46
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• 2014

Asymmetric sitting posture may cause asymmetric buttock pressure and unilateral low back pain (LBP). The purpose of this study was to compare the differences of buttock pressure between both sides, and pelvic angle (sagittal and coronal planes) during typing in a sitting position on a pressure mat (Baltube) in individuals with and without unilateral LBP. Ten subjects with unilateral LBP and ten subjects without unilateral LBP were recruited for this study. Buttock pressure was measured using a pressure mat and pelvic angles were measured using a palpation meter. The subjects performed typing in a sitting posture for 30 minutes. Pressure data were collected and averaged at initial term (from start to first minutes) and final term (last minutes of 30 minutes). Angles of pelvic tilting were measured after 30 minutes typing. Pressure asymmetry values (difference in pressure between both sides) were calculated at the initial and final terms. A two-way analysis of variance was used to compare the differences between the initial and final pressure asymmetry values in subjects with and without unilateral LBP. An independent t-test was applied to compare the pelvic tilt angles between the two groups. To compare the change of pressure from the initial term to the final term between the symptomatic and asymptomatic sides in the unilateral LBP group, a paired t-test was applied. In the unilateral LBP group, the pressure asymmetric value at the final term was significantly greater than that of the initial term (p<.05). The angle of pelvic tilting in coronal plane was significantly greater in the unilateral back pain group compared to the without unilateral LBP group (p<.05), however, there was no significant difference in the angle of pelvic tilting in the sagittal plane between the two groups (p>.05). In the unilateral LBP group, the change of pressure from the initial term to the final term was significantly less in the symptomatic side (-6.90 mmHg) than the asymptomatic side (5.10 mmHg). This asymmetric sitting posture may contribute to unilateral LBP in the sitting position. Further studies are needed to determine if asymmetric weight bearing in sitting causes unilateral LBP or if unilateral back pain causes asymmetric weight bearing, and if the correction of asymmetric weight bearing in sitting can reduce unilateral LBP.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2002.05a
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• pp.121-123
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• 2002

The design of an air seat cushion for preventing decubitus ulcer includes many design factors such as the even distribution of interface pressure, the minimization of mean and peak interface pressure values, and the reduction of interface shear force and pressure gradient. It involves the anatomic condition of plegia's buttock as well as air pressure in air cells of cushion. As a result, a suitable design of the cushion satisfying the all requirements is a difficult problem. Therefore, an appropriate and effective numerical tool to develop an air cushion orthosis is required. The purpose of the present study was to develop an air seat cushion orthosis having optimized air cells for evenly distributed interface pressure between the buttock and cushion surface. For the purpose, an advanced finite element (FE) model for the design of air cushion was developed. Since the interface pressure and shear force behavior, as well as stress analyses were primary concern, a FE air cell model was developed and verified by the experiments. Then, the interactions of two cells were checked. Also, the human part of the developed numerical model includes every material property and geometry related to buttock and femoral parts. For construction of dimension data of buttock and femoral parts, CT scans were performed. A commercial FE program was employed for the simulation representing the seating process on the orthosis. Then, sensitive analyses were performed with varying design parameters. A set of optimal design parameters was found satisfying the design criteria of the orthosis. The results were utilized to produce a prototype of the orthosis. Experimentally, the buttock interface pressure distributions from the optimized and previous ones were compared. The new seat orthosis showed a significantly improved interface pressure characteristics compared to the most popular one in the market. The new orthosis will be used for the development of the AI(artificial intelligent) controlled seat orthosis fur prevention of decubitus ulcer fur various plegic patients and the elderly.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.6 no.1
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• pp.5-13
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• 2000

This evaluation was made through 11 persons who discogenic disease and it emergency disease. There was all complains low back. with sustained buttock pain with radiating to the leg due to piriformis syndrome during the period of march 2000 to November 1999 in seoul wooridul hospital. The purpose of this study was to determine the effect of manual therapy through 11 persons. The results were as follow : 1. Right buttock pain group(n = 11). there was significant difference before manual treatment(P<.05). 2. Pain decreased before Tx then after Tx by VAS.

• The Korean Journal of Cytopathology
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• v.10 no.1
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• pp.85-89
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• 1999

An extremely unusual case of epidermoid cyst showing diffuse parakeratosis and aggressive clinical behavior is presented. A destructive bone lesion with surrounding ill-defined soft tissue lesion was found by computed tomography in a 63 year-old man complaining of painful swelling of the right buttock. He had a history of surgical excision twice for epidermoid cysts of soft tissue of the right hip during recent one year On aspiration cytology, the aspirate was highly cellular and mostly composed of desquamated nucleated squamous cells. Operation finding revealed that the iliac bone was Irregularly destroyed and filled with gray-white cheesy material and necrotic bone bedris. Adjacent gluteus muscle showed scattered gray-white lesions. The curettage specimen showed bone necrosis and desquamated squamous cells filling the marrow spaces. The lesion within muscle revealed epidermoid cyst with diffuse parakeratosis.

• Journal of Korean Neurosurgical Society
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• v.38 no.3
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• pp.196-201
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• 2005

Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

• Archives of Plastic Surgery
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• v.41 no.2
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• pp.133-139
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• 2014

Background Various shapes and designs of the gluteal artery perforator flap have been used for treating sacral pressure sores and reconstructing breasts. To establish the ideal fasciocutaneous flap design for use in the gluteal area, the soft tissue thickness distribution was measured. Methods Twenty-one buttocks of adult Korean cadavers were analyzed through rectangular subfascial dissection. Each buttock was divided horizontally into 10 sections and vertically into 10 sections, and then, the thickness at the corners of the sections was measured. For the sake of comparison and statistical verification with living bodies, computed tomography (CT) images of 120 buttocks of patients were randomly selected. Five horizontal sections and 4 vertical sections were made, and the thickness at each corner was recorded. Results According to the dissection and the CT images, the area with the thinnest soft tissues in the buttock was around the posterior superior iliac spine, close to the sacral area. The thickest area was the superolateral area of the buttock, which was 3.24 times and 2.15 times thicker than the thinnest area in the studies on cadaver anatomy and the CT images, respectively. Conclusions The thickness of the soft tissues in the buttocks differed by area. The superolateral area had the thickest soft tissues, and the superomedial area had the thinnest. This study includes information on the distribution of the thickness of the gluteal soft tissues of Koreans. The outcome of this study may contribute to the design of effective local flaps for pressure sore reconstruction and free flaps for breast reconstruction.