• PNF and Movement
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• 제1권1호
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• pp.43-57
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• 2003

목적: 병원치료가 필요하지 않을 만큼의 경부통증/증상과 관절가동범위, 경흉추의 다각적 면에서 관계를 조사하기 위해서이다. 방법: 연령은 19세에서 42세(평균연령 28세로 실험에 참여하기를 원하는 건강한 성인 40명을 대상으로 하였다. 경흉추의 척추 자세, 경추 능동 관절 가동범위, 경부 분절 길이 등의 다각적인 면을 측정하였다. 모든 측정들은 동일시에 각 대상자에게 서로 다른 측정자에 의해 두 번 실시되었다. 경부 근 지구력은 수정된 Biering-Sorensen 검사법에 의해 측정되었다. 마지막으로 대상자들에게 경부 통증/증상의 재발에 대한 질문을 하였다. 결과: 14명의 대상자들은 경미한 재발성 경부 통증/증상을 보고하였다. 경부 근 지구력 시간(F(1,38)=6.75, p=0.01)과 좌측 회전 가동 범위(F(1,38)=4.56, p=0.04)가 경부 통증을 가진 대상자들에서 유의하게 감소하였다. 신전 가동범위가 재 측정에서 특정군 변화 즉, 정상군 증가, 경부 통증/증상군 감소(F(1,38)=4.67, p=0.04)가 보였다. 경부 통증/증상군은 정상군과 비교 시 후인 가동 범위의 증가하였다(F(1,38) =4.56, p=0.04). 통증 유무에 관계없이 모든 대상자들에서 우측 회전보다 좌측 회전에서 가동범위가 더 크게 나타났고(F(1,38) =4.34, p=0.04), 반복 측정에서 좌측 측방굴곡 (F(1,38) =5.10, p=0.03)과 우측 측방 굴곡(F(1,38) = 5.27, p=0.03)의 감소가 나타났다. 결론: 경미한 증상의 경부통증 대상자군과 정상적인 대상자군을 비교할 때 그룹 간 차이는 경부 근 지구력 시간의 감소, 좌측 회전 가동 범위 감소와 특히, 두 번 째 측정에서 신전범위 감소가 나타났으나 후인의 가동범위는 증가로 관찰되었다. 이러한 결과들은 경부 통증의 발생과 관련된 초기 가동범위 변화를 제안한다.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.38-42
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• 2014

Objective: In this study, we applied a neurodynamic sciatic nerve sliding technique to healthy adults to elucidate its effects on hamstring flexibility and postural balance. Design: Cross-sectional study. Methods: This study targeted twenty four healthy adults (16 men, 8 women). A neurodynamic sciatic nerve sliding technique was applied 5 times to all subjects' dominant leg. The subjects were asked to sit on the bed while performing cervical and thoracic flexion, as well as knee flexion with ankle plantar flexion. Then, they were asked to perform cervical and thoracic extension and knee extension with their ankle in dorsiflexion and maintain the position for 60 s. For postural balance, we measured postural sway while the subjects maintained a one-legged standing posture using the Good Balance System and measured the hip joint flexion range of motion using a standardized passive straight leg raise (SLR) test. Results: SLR test increased significantly from $79^{\circ}$ before the intervention to $91.67^{\circ}$ after the intervention (p<0.05). Regarding the participants' balance evaluated using the one-legged standing test, the X-speed decreased significantly from 18.61 mm/s to 17.17 mm/s (p<0.05), the Y-speed decreased from 22.28 mm/s to 20.52 mm/s (p<0.05), and the velocity moment was significantly decreased from $89.33mm^2/s$ to $74.99mm^2/s$ after the intervention (p<0.05). Conclusions: Application of the neurodynamic sciatic nerve sliding technique exhibited improved hamstring flexibility and postural balance of healthy adults.

• Journal of Korean Neurosurgical Society
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• 제59권5호
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• pp.471-477
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• 2016

Objectives : The correction of clinical and radiologic abnormalities in patients with symptomatic ossification of the posterior longitudinal ligament (OPLL) is the current mainstay of treatment. This study aimed to identify radiographic predictors of severity of myelopathy in patients with symptomatic OPLL. Methods : Fifty patients with symptomatic cervical OPLL were enrolled. Based on Japanese Orthopedic Association (JOA) scores, patients were divided into either the mild myelopathy (n=31) or severe myelopathy (n=19) group. All subjects underwent preoperative plain cervical roentgenogram, computed tomography (CT), and MR imaging (MRI). Radiological parameters (C2-7 sagittal vertical axis, SVA; C2-7 Cobb angle; C2-7 range of motion, ROM; OPLL occupying ratio; and compression angle) were compared. Compression angle of OPLL was defined as the angle between the cranial and caudal surfaces of OPLL at the maximum level of cord compression Results : The occupying ratio of the spinal canal, C2-7 Cobb angle, C2-7 SVA, types of OPLL, and C2-7 ROM of the cervical spine were not statistically different between the two groups. However, the OPLL compression angle was significantly greater (p=0.003) in the severe myelopathy group than in the mild myelopathy group and was inversely correlated with JOA score (r=-0.533, p<0.01). Furthermore, multivariate regression analysis demonstrated that the compression angle (B=-0.069, p<0.001) was significantly associated with JOA scores (R=0.647, p<0.005). Conclusion : Higher compression angles of OPLL have deleterious effects on the spinal cord and decrease preoperative JOA scores.

• Journal of Korean Neurosurgical Society
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• 제39권3호
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• pp.188-191
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• 2006

Objective : The purpose of this study is to evaluate the efficacy and necessity of combined anterior approach [discectomy and fusion] and posterior approach[open-door laminoplasty] in the treatment of cervical spondylotic myelopathy. Methods : The authors reviewed 14 cases in whom combined anterior and posterior approach performed for cervical myelopathy due to simultaneous anterior and posterior pathology such as huge central disc herniation with narrow spinal canal between January 2000 and December 2002. Clinical symptoms were evaluated by Japanese Orthopaedic Association [JOA] score and then the cervical curvature, change of spinal canal to vertebral body[SC/VB] ratio and canal widening were measured and compared to the clinical symptoms. Results : The mean JOA score increased from $10.4{\pm}3.1$ preoperatively to $14.8{\pm}1.2$ at the final follow up with a mean recovery rate 66.4%. In all cases, there were not neurologic deterioration. Mild postoperative complications developed in two cases. One patient had a limitation of range of neck motion and the other one showed kyphotic change. Postoperative radiography showed an improvement of body to canal ratios [average $0.70{\pm}0.08$ before surgery to $1.05{\pm}0.12$ after surgery and mainte nance or recovery of cervical lordosis. Canal widening of antero-posterior diameter and dimension after operation is 6.8mm. $116.61mm^2$. Conclusion : Combined anterior and posterior procedure could be helpful in decompression of the spinal cord and good functional recovery in spondylotic myelopathy patients with combined anterior and posterior pathology such as huge disc herniation accompanying narrow spinal canal.

• Journal of Veterinary Science
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• 제25권1호
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• pp.2.1-2.14
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• 2024

Background: Sufficient surgical resection is necessary for effective tumor control, but is usually limited for vertebral tumors, especially in the cervical spine in small animal neurosurgery. Objective: To evaluate the primary stability and safety of customized three-dimensional (3D)-printed implants for cervical spine reconstruction after total vertebrectomy. Methods: Customized guides and implants were designed based on computed tomography (CT) imaging of five beagle cadavers and were 3D-printed. They were used to reconstruct C5 after total vertebrectomy. Postoperative CT images were obtained to evaluate the safety and accuracy of screw positioning. After harvesting 10 vertebral specimens (C3-C7) from intact (group A) and implanted spines (group B), implant stability was analyzed using a 4-point bending test comparing with groups A and C (reconstituted with plate and pins/polymethylmethacrylate after testing in Group A). Results: All customized implants were applied without gross neurovascular damage. In addition, 90% of the screws were in a safe area, with 7.5% in grade 1 (< 1.3 mm) and 2.5% in grade 2 (> 1.3 mm). The mean entry point and angular deviations were 0.81 ± 0.43 mm and 6.50 ± 5.11°, respectively. Groups B and C significantly decreased the range of motion (ROM) in C3-C7 compared with intact spines (p = 0.033, and 0.018). Both groups reduced overall ROM and neutral zone in C4-C6, but only group B showed significance (p = 0.005, and 0.027). Conclusion: Customized 3D-printed implants could safely and accurately replace a cervical vertebra in dog cadavers while providing primary stability.

• 대한물리의학회지
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• 제11권1호
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• pp.71-82
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• 2016

PURPOSE: The purpose of this case report was to determine the effect of therapeutic exercise on posture, pain, and muscle activity in two patients with forward head posture (FHP). METHODS: A-31-year-old male (patient A) and a 19-year-old women (patient B) presented with FHP, neck pain, and headache. The therapeutic exercise program consisted of cervical mobilization, deep cervical flexors strengthening, and cervical extensors stretching, for 40 min/d, 2 d/week, for 8 weeks. Neck pain (VAS), neck disability (NDI), cervical range of motion (CROM), lateral view of cervical spine X-ray (indicating the FHP), and asymmetrical neck and shoulder muscular activity ratio were measured before, after 4 weeks, and after 8 weeks of corrective exercise. RESULTS: VAS and NDI decreased in patients A and B after exercise compared to before the program. CROM increased in patients A and B at flexion, extension, side bending, and rotation after exercise compared to before the program. FHP decreased in patients A and B at distance after exercise compared to before the program. In addition, asymmetrical neck and shoulder muscles activity ratio improved in patients A and B after exercise compared to before the program. CONCLUSION: We demonstrated in a case report that therapeutic exercise increases ROM, decreases pain and disability of neck, FHP, and asymmetry muscle activity ratio in patients with FHP. These finding have clinical implications for therapeutic exercise in patients with FHP.

• 대한정형도수물리치료학회지
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• 제28권2호
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• pp.35-44
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• 2022

Background: This study aimed to compare the effects of the Mulligan mobilization with movement and McKenzie exercise after applying conservative physical therapy to patients with knee pain. Methods: Patients were randomly allocatied into two groups: the Mulligan mobilization with movement (10 subjects) and the McKenzie technique (10 subjects). Each group was givenr conservative physical therapy and manual therapy sessions, three times week, for four weeks. The pain intensity was measured using the visual analogue scale (VAS). The cervical range of motion (ROM) was measured with a goniometer. Balance was measured using the modified Berg balance scale (BBS). Results: After four weeks of therapy, VAS (p<.05) decreased significantly, and ROM and balance increased siginficantly in both groups(p<.05). There was a significant improvement in knee extension (p<.05) in the McKenzie group compared to the Mulligan group. No intergroup differences were found with respect to the knee flex, VAS, and BBS (p>.05). Conclusion: The McKenzie exercises are more effective than Mulligan mobilization with movement for improving knee extension. Both interventions have the same effects on pain relief, in increasing knee flexion ROM and improving balance in patients with knee pain.

• 한국방사선학회논문지
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• 제9권7호
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• pp.479-486
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• 2015

본 연구는 만성 경부통증 환자에게 Kaltenborn-Evjenth concept에 기초한 상부흉추 관절가동술 적용이 경흉추 관절 가동범위와 통증에 미치는 영향을 알아보고자 하였다. Kaltenborn-Evjenth concept은 작은 진폭의 도수요법으로 관절낭이나 연부조직에 스트레스를 주지 않고 해당부위의 관절 또는 근육을 칼텐본 등급에 따라 정형도수치료를 하는 수기요법이다. 연구 대상자는 상부흉추 관절가동술군 7명과 보존적 물리치료군 7명으로 나뉘어 각각 주 3회, 4주간 흉추 관절가동술과 보존적 물리치료(온습포 치료, 간섭파, 초음파 치료)를 시행 받았다. 측정은 실험 전과 실험 2주, 실험 4주, 실험 후 4주에서 흉추 분절별 가동범위와 통증, 경추 가동범위를 측정하였다. 흉추 분절별 가동범위는 Spinal Mouse를 이용하여 흉추 1-2분절, 2-3분절, 3-4분절의 굴곡-신전 값을 측정하였고, 통증은 VAS(visual analogue scale)를 이용하여 측정하였습니다. 경추 가동범위(굴곡, 신전, 굴곡-신전)는 관절각도계(Inclinometer, Dualer IQ)를 이용하여 측정하였고, 상부흉추 관절가동술이 만성통증 환자에게 있어서 관절 가동범위의 변화와 자세 및 기능개선에서 도움이 된 것으로 나타났다.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.567-576
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• 2017

Objective : Preoperative parameters including the T1 slope (T1S) and C2-C7 sagittal vertical axis (SVA) have been recognized as predictors of kyphosis after laminoplasty, which is accompanied by posterior neck muscle damage. The importance of preoperative parameters has been under-estimated in anterior cervical discectomy and fusion (ACDF) because there is no posterior neck muscle damage. We aimed to determine whether postoperative subsidence and pseudarthrosis could be predicted according to specific parameters on preoperative plain radiographs. Methods : We retrospectively analyzed 41 consecutive patients (male : female, 22 : 19; mean age, $51.15{\pm}9.25years$) who underwent ACDF with a stand-alone polyether-ether-ketone (PEEK) cage (>1 year follow-up). Parameters including SVA, T1S, segmental angle and range of motion (ROM), C2-C7 cervical angle and ROM, and segmental inter-spinous distance were measured on preoperative plain radiographs. Risk factors of subsidence and pseudarthrosis were determined using multivariate logistic regression. Results : Fifty-five segments (27 single-segment and 14 two-segment fusions) were included. The subsidence and pseudarthrosis rates based on the number of segments were 36.4% and 29.1%, respectively. Demographic data and fusion level were unrelated to subsidence. A greater T1S was associated with a lower risk of subsidence (p=0.017, odds ratio=0.206). A cutoff value of T1S<$28^{\circ}$ significantly predicted subsidence (sensitivity : 70%, specificity : 68.6%). There were no preoperative predictors of pseudarthrosis except old age. Conclusion : A lower T1S (T1S<$28^{\circ}$) could be a risk factor of subsidence following ACDF. Surgeons need to be aware of this risk factor and should consider various supportive procedures to reduce the subsidence rates for such cases.

• 한국전문물리치료학회지
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• 제20권1호
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• pp.47-54
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• 2013

The purpose of this study was to compare the immediate effects of upper trapezius muscle stretching in more tensed position (MTP) and less tensed position (LTP) on the change of range of motion (ROM) for neck rotation, and the ROM for conjunct neck motions at end-range of neck rotation toward the painful side in patients with unilateral neck pain. Eighteen patients with unilateral neck pain were recruited for the study's MTP group, and 18 age-, weight- and gender-matched patients with unilateral neck pain were recruited for LTP group. The ROM changes in active neck primary and conjunct motions were measured using a cervical ROM inclinometer in the sitting position. Our results showed that both upper trapezius stretching method in MTP and LTP were significantly effective in increasing the ROM of neck rotation toward painful side in patients with unilateral neck pain. However, a significantly greater increase in the ROM for neck rotation and a further decrease in conjunct neck extension during neck rotation toward the painful side were shown in MTP group, compared to LTP group. The upper trapezius stretching in MTP is useful in increasing the ROM of neck rotation and decreasing the range of conjunct neck extension during neck rotation toward the painful side in patients with unilateral neck pain.