• PNF and Movement
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• v.19 no.1
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• pp.127-135
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• 2021

Purpose: The purpose of this study was to determine the effect of the side-bridge exercise on the thicknesses of the external and internal obliques, the transverse abdominis, and the erector spinae, which are some of the trunk muscles of healthy adult males and females. Methods: There were 30 subjects divided into two groups with 15 subjects in the modified side-bridge exercise group and 15 subjects in the bridge exercise group. The changes in each variable were analyzed before the exercise, after three weeks, and after six weeks of exercise using a two-way repeated analysis of variance. The significance level was set at 0.05. When there was any interaction between the time of measurement and each group, a paired t-test was conducted to find the difference within groups and an independent-sample t-test was conducted to find the difference between groups. The significance level for both tests was set at 0.01. Results: There was a significant difference in the external and internal obliques and the erector spinae according to changes over time and the interactions between the time and groups (p < 0.05). However, there was a significant difference in the transverse abdominis only according to the interaction between the length of times (p < 0.05). Conclusion: The study results indicated that the modified side-bridge exercise significantly increased the thickness of the external and internal obliques and the erector spinae. This suggests the usability of the exercise in lumbar stabilization exercises in future studies and clinical fields.

• Physical Therapy Korea
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• v.28 no.1
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.11-22
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• 2021

Background: This study was to investigate the effects of active stretching and stability exercise on piriformis muscle thickness and low back pain of male patients with chronic low back pain. Design: Randomized Controlled Trial. Methods: 45 male patients participated in this study. All subjects were randomly assigned. Subjects divided into 15 who underwent contract relaxation (CR) of the proprioceptive neuromuscular facilitation (PNF) to their hip joints, 15 who underwent a combination of isotonic (CI) of the PNF, and the rest 15 who underwent the two techniques (CR+CI). Real-time diagnostic ultrasound was used to measure thickness of the piriformis muscles. The visual analogue scale (VAS) was used to measure degrees of low back pain. A two-way repeated measures ANOVA was used to compare the average values. The SPSS 24.0 was used as the statistical program, and the significance level was set at .05. Results: The CR and the CR+CI groups had more decreased thickness of piriformis muscle when compared to the CI group. The CR+CI group had more decreased pain when compared to the CR and the CI groups. Conclusion: These results suggest that combination of stretching and stability exercise was effective on male patients with chronic low back pain showing limited hip medial rotation.

• Journal of Trauma and Injury
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• v.35 no.1
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• pp.12-18
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• 2022

Purpose: Pedicle screw fixation provides 3-column stabilization, multidimensional control, and a higher rate of interbody fusion. Although computed tomography (CT) is recommended for the postoperative assessment of pedicle screw fixation, its use is limited due to the radiation exposure dose. The purpose of this preliminary retrospective study was to assess the clinical usefulness of low-dose mobile cone-beam CT (CBCT) for the postoperative evaluation of pedicle screw fixation. Methods: The author retrospectively reviewed postoperative mobile CBCT images of 15 patients who underwent posterior pedicle screw fixation for spinal disease from November 2019 to April 2020. Pedicle screw placement was assessed for breaches of the bony structures. The breaches were graded based on the Heary classification. Results: The patients included 11 men and four women, and their mean age was 66±12 years. Of the 122 pedicle screws, 34 (27.9%) were inserted in the thoracic segment (from T7 to T12), 82 (67.2%) in the lumbar segment (from L1 to L5), and six (4.9%) in the first sacral segment. Although there were metal-related artifacts, the image of the screw position (according to Heary classification) after surgery could be assessed using mobile CBCT at all levels (T7-S1). Conclusions: Mobile CBCT was accurate in determining the location and integrity of the pedicle screw and identifying the surrounding bony structures. In the postoperative setting, mobile CBCT can be used as a primary modality for assessing the accuracy of pedicle screw fixation and detecting postoperative complications.

• Physical Therapy Korea
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• v.30 no.2
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• pp.144-151
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• 2023

Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.

• Physical Therapy Korea
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• v.18 no.3
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• pp.67-75
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• 2011

The purpose of this study was to assess the agreement of manual muscle testing (MMT) and test-retest reliability of a hand held dynamometer for the posterior gluteus medius muscle, with and without lumbar stabilization, using a pressure biofeedback unit for patients with low back pain. The pressure biofeedback unit was used to minimize the substitute motion of the lumbopelvic region during hip abduction in patients lying on their side. Fifteen patients with low back pain participated in this study. A tester determined the MMT grades of the posterior gluteus medius with and without the pressure biofeedback unit. Active hip abduction range of motion with an inclinometer and the strength of their posterior gluteus medius using a hand held dynamometer were measured with and without the pressure biofeedback unit in the MMT position. The agreement of the grade of muscle strength in the MMT, and intra-rater reliability of both the active hip abduction range of motion and the strength of posterior gluteus medius were analyzed using the weighted kappa and intraclass correlation coefficient (ICC), respectively. The agreement of MMT with the pressure biofeedback unit (weighted kappa=.92) was higher than the MMT (weighted kappa=.34)(p<.05). The inclinometer with pressure biofeedback unit measurement of the active hip abduction range of motion had an excellent intra-rater reliability (ICC=.90). Also, the hand held dynamometer with pressure biofeedback unit measure of strength of the posterior gluteus medius had a good intra-rater reliability (ICC=.85). Therefore, the test for muscle strength with pressure biofeedback unit will be a reliable method for the determination of the MMT grades or amount of posterior gluteus medius muscle strength and the measurement of the range of motion for hip abduction in patients with low back pain.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.58-65
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• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.1
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• pp.45-51
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• 2021

The purpose of this study was to investigate the effect of applying whole body vibration exercise at 30 Hz on the thickness and mechanical properties of the erector spinae. The study population included 24 adults (11 male and 13 female) in the N region. The subjects were divided into two groups, a 30Hz whole body vibration exercise(WG, n=12) and an LSG(12 subjects). Changes in the thickness and mechanical properties of the erector spinae were analyzed before the exercises and after four and eight weeks of exercises using a two-way repeated analysis of variance with a statistical significance level of α=0.05. When there was an interaction between the groups and measurement times, post hoc analyses were conducted at a statistical significance level of α=0.01. The thickness, frequency, stiffness and strain of the erector spinae muscles were significantly different in each time period and in the interaction between time period and the group (P<0.05), and recovery was significantly different only in each time period (P<0.05). Thus, 30Hz whole body vibration exercise had a positive effect on the thickness and mechanical properties of the erector spinae. The results of this preliminary study suggest that whole body vibration exercise may find a place as a lumbar stabilization exercise in clinical practice in the future.

• Journal of Korea Entertainment Industry Association
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• v.14 no.6
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• pp.221-230
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• 2020

The purpose of this study was to investigate the effect of resistance exercise with vibration stimulation methods on static balance and gait parameters in experienced back pain adults. This study was Three group pretest-posttest design. A total of 30 experienced back pain adults voluntarily participated in the study. Subjects were randomly assigned to the resistance exercise with 8 Hz vibration stimulation(n=10), resistance exercise with 30 Hz vibration stimulation(n=10), and lumbar stabilization exercise groups(n=10). The static balance and the gait parameters, as such stance phase, swing phase, stride length and cadence, were measured using balance measuring equipment and gait analysis treadmill at before and after 6 week. Intervention of each group were performed, three times a week for 6 weeks, and 30 minutes a day. The effect of intervention on static balance, stance phase, swing phase, stride length and cadence were significantly differences after 6 weeks in each group(p<.05). In the comparison of the effects between the groups, static balance and stance phase were significantly difference after 6 weeks(p<.05), but in the swing phase, stride length and cadence, there were no significant differences. As a result, it is considered that resistance exercise with vibration stimulation improved leg muscle strength by a mechanism causing muscle contraction, and the strengthened leg muscle enhanced had a positive effect on balance ability. And improved balance ability was considered a more positive effect on walking ability by allowing the body to stably control posture while moving.