• Title/Summary/Keyword: Lumbar range of motion

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A Patient with Ankylosing Spondylitis Treated with Acupotomy and Traditional Korean Medicine

  • Kim, Beom Seok;Kim, Jae Ik;Kim, Hyo Bin;Lee, Ye Ji;Sung, Ki Jung;Jeon, Ju Hyun;Kim, Eunseok;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.36 no.3
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    • pp.172-181
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    • 2019
  • This case report relates to a 40-year old male patient diagnosed with ankylosing spondylitis who was treated with acupotomy and traditional Korean medicine. He showed a significant improvement in joint range of motion (ROM) in cervical and lumbar vertebrae, and in pain and functional disorder symptoms. The patient received acupotomy, acupuncture, pharmacopuncture, herbal medicine and physical therapy (November 26, 2018 to December 17, 2018). Joint ROM for cervical and lumbar vertebrae was measured, and the pain level was assessed using a numerical rating scale. The functional disorder and quality of life scales were also assessed using the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Korean Health Assessment Questionnaire, and Modified Health Assessment Questionnaire. After applying acupotomy and traditional Korean medicine, the patient exhibited increased joint ROM and reduced pain, also in conjunction with improved responses in functional disorder and quality of life.

The Comparison of Biomechanical Changes between Spinous Process Osteotomy and Conventional Laminectomy (극돌기 절골술과 추궁판 절제술에 대한 생체역학적 비교)

  • Kang, Kyoung-Tak;Chun, Heoung-Jae;Son, Ju-Hyun;Kim, Ho-Joong;Moon, Seong-Hwan;Lee, Hwan-Mo;Kim, Ka-Yeon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.33 no.7
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    • pp.645-651
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    • 2009
  • Previous studies have introduced the technique of spinous process osteotomy to decompress spinal stenosis, a procedure which aims to afford excellent visualization while minimizing destruction of tissues not directly involved in the pathologic process. However, biomechanically it has not been investigated whether the sacrifice of posterior spinous process might have potential risk of spinal instability or not, even though supra-spinous and inter-spinous ligaments are preserved. Therefore the aim of this study is to evaluate the biomechanical properties after spinous process osteotomy, using finite element analysis. The model of spinous process osteotomy exhibited no significant increase in disc stress or change in segmental range of motion. It is due to the fact that the instability of lumbar spine has been maintained by the two-types of ligaments compared with the prior surgical technique. Therefore, according to the finite element result on this study, this osotetomy was considered to be a clinically safe surgical procedure and could not cause the instability of the lumbar spine.

A Study on the Design of Low Back Muscle Evaluation System Using Surface EMG (표면근전도를 이용한 허리근육 평가시스템의 설계에 관한 연구)

  • Lee Tae-Woo;Ko Do-Young;Jung Chul-Ki;Kim In-Soo;Kang Won-Hee;Lee Ho-Yong;Kim Sung-Hwan
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.54 no.5
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    • pp.338-347
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    • 2005
  • A computer-based low back muscle evaluation system was designed to simultaneously acquire, process, display, quantify, and correlate electromyographic(EMG) activity with muscle force, and range of motion(ROM) in the lumbar muscle of human. This integrated multi-channel system was designed around notebook PC. Each channel consisted of a time and frequency domain block, and T-F(time-frequency) domain block. The captured data in each channel was used to display and Quantify : raw EMG, histogram, zero crossing, turn, RMS(root mean square), variance, mean, power spectrum, median frequency, mean frequency, wavelet transform, Wigner-Ville distribution, Choi-Williams distribution, and Cohen-Posch distribution. To evaluate the performance of the designed system, the static and dynamic contraction experiments from lumbar(waist) level of human were done. The experiment performed in five subjects, and various parameters were tested and compared. This system could equally well be modified to allow acquisition, processing, and analysis of EMG signals in other studies and applications.

Interspinous Implant with Unilateral Laminotomy for Bilateral Decompression of Degenerative Lumbar Spinal Stenosis in Elderly Patients

  • Ryu, Sung-Joo;Kim, In-Soo
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.338-344
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    • 2010
  • Objective : This study assessed the safety and efficacy of one level unilateral laminotomy bilateral decompression (ULBD) with the placement of a device for intervertebral assisted motion (DIAM) compared with one level ULBD only in elderly patients with degenerative lumbar spinal stenosis (DLSS). Methods : A non randomized prospective analysis was performed on 16 patients who underwent one level ULBD with DIAM (Group A) and 20 patients with one level ULBD only (Group B) between February 2007 and March 2008. Radiographic imaging, visual analog scale (VAS) and MacNab outcome scale were obtained before and after surgery at a mean interval of 21 months (range 17-27 months). Results : The disc height, interpedicular distance, slip distance and segmental lordotic angle were similar between two groups. In the group A, there was no significant difference between the pre- and post-operative imaging in terms of the sagittal balance and disc height. Both groups showed significant improvement in the clinical outcomes. In addition, there was significantly less low-back pain in the group A than in the group B at the last follow up, while the clinical improvement of the leg pain and MacNab outcome scale showed no significant difference in the two groups. There were no major complications or DIAM associated complications. Conclusion : ULBD with DIAM is a safe and efficacious treatment for selective elderly patients with DLSS, particularly for relieving low back pain comparing to ULBD. ULBD with DIAM did not alter the disc height or sagittal alignment at the mean 21 months follow-up interval.

Analysis of Kinematic Parameters of Gait in Normal Subject (정상 성인의 운동 형상학적 보행 분석)

  • Jung, Hwa-Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.5
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    • pp.2989-2995
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    • 2014
  • This study was to performed to get the reference data of the kinematic parameters for normal subjects according to the arm movement type. Forty-five normal subjects participated in this study and preformed four sequence according to the arm movement type : normal arm movement, one arm movement, no arm movement, fitness arm movement. The study data was collected from June to August 2010. The kinematic data were measured using Vicon motion system 6MX3 cameras while each subjects walked through a 10m walkway. There were significant differences according arm movement type in the kinematic parameters such as range of motion (ROM) of the right pelvic, hip in sagittal plane, and ROM of the pelvic, hip, lumbar in coronal plane and ROM of the pelvic, thoracic, lumbar in transverse plane. This study can be utilized as the basic reference data in gait analysis for patients with pathologic gaits.

Agreement of Manual Muscle Testing and Test-Retest Reliability of Hand Held Dynamometer for the Posterior Gluteus Medius Muscle for Patients With Low Back Pain (요통 환자를 대상으로 후중둔근 도수근력검사의 일치도 및 휴대용 근력계 측정 방법의 신뢰도 검사)

  • Park, Kyue-Nam;Kim, Hyun-Sook;Choi, Houng-Sik;Lee, Won-Hwee;Ha, Sung-Min;Kim, Su-Jung
    • 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.

The Effect of Vision and Proprioception on Lumbar Movement Accuracy (시각과 고유수용성 감각이 요부 운동의 정확도에 미치는 영향)

  • Sim, Hyun-Po;Yoon, Hong-Il;Youn, I-Na
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.31-44
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    • 2007
  • The purposes of this study were to examine the normal lumbar proprioception and identify the effect of vision and proprioception on lumbar movement accuracy through measuring a reposition error in visual and non-visual conditions and to provide the basic data for use of vision when rehabilitation program is applied. The subjects of this study were 39 healthy university students who have average physical activity level. They were measured the ability to reproduce the target position(50% of maximal range of motion) of flexion, extension, dominant and non-dominant side flexion in visual and non-visual conditions. Movement accuracy was assessed by reposition error(differences between intended and actual positions) that is calculated by the average of absolute value of 3 repeated measures at each directions. The data were analysed by paired samples t-test, independent samples t-test, and repeated measures ANOVA. The results were as follows : 1. Movement accuracy of flexion, extension, dominant side flexion, and non-dominant side flexion was increased in visual condition. 2. There were no differences in the lumbar movement accuracy between sexes in visual and non-visual conditions. 3. In non-visual condition, the movement in coronal plane(dominant and non dominant side flexion) is more accurate than that in sagittal plane(flexion and extension). 4. In non-visual condition, there were no differences in the lumbar movement accuracy between dominant and non-dominant side flexion. In conclusion, this study demonstrates that the movement is more accurate when the visual information input is available than proprioception is only available. When proprioception is decreased by injury or disease, it disturbs the control of posture and movement. In this case, human controls the posture and movement by using visual compensation. However it is impossible to prevent an injury or trauma because most of injuries occur in an unexpected situation. For this reason, it is important to improve the proprioception. Therefore, proprioceptive training or exercise which improve the ability to control of posture and movement is performed an appropriate control of permission or interception of the visual information input to prevent an excessive visual compensation.

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A Clinical Study of Two Foot Drop Patients with Herniated Intervertebral Lumbar Disc treated by Acupuncture Treatment on Peroneus Longus Muscle (요추간판 탈출증에 동반된 편측 족하수 환자 치험 2례 - 장비골근 침치료 중심으로)

  • Lee, Han;Cho, Jae-Hee;Lee, Hyo-Eun;Jung, Ho-Suk;Kim, Eun-Seok;Han, Kyung-Wan;Yang, Dong-Ho;Yoo, In-Sik
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.173-184
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    • 2009
  • Objectives : The purpose of this study is to report clinical effects of oriental medical treatments with acupuncture treatment on peroneus longus muscle for two patients with foot drop by Herniated Intervertebral Lumbar Disc(HIVD). Method : The patients were diagnosed as HIVD, and were treated by oriental medical treatments including acupuncture treatment on peroneus longus muscle. And we measured Visual Analogue Scale(VAS), Range of Motion (ROM) of ankle joint, Manual Muscle testing(MMT) and checked the subject power of ankle joint. Result : After acupuncture treatment on peroneus longus muscle, the movement and power of ankle joint were improved in two cases. Conclusion : Acupuncture treatment on peroneus longus muscle showed significant effect on two patients with foot drop patients by HIVD.

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Acute effect of self-myofascial release using a foam roller on the plantar fascia on hamstring and lumbar spine superficial back line flexibility

  • Do, Kwangsun;Kim, Jaeeun;Yim, Jongeun
    • Physical Therapy Rehabilitation Science
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    • v.7 no.1
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    • pp.35-40
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    • 2018
  • Objective: The purpose of this study was to investigate the immediate effect of applying self-myofascial release (SMR) to the plantar fascia using a foam roller on hamstring and lumbar spine superficial back line (SBL). Design: Randomized controlled trial. Methods: Thirty-one healthy adults agreed to the method and purpose of the study. Selection and exclusion criteria were screened, and baseline measurements for the Toe Touch test and passive straight leg raise (PSLR) test were obtained. The participants were then randomly assigned to the SMR group or the sham group. After group assignment, the SMR group rolled the surface of the foot from the heel to the metatarsal head using a foam roller for 5 minutes. The sham group received passive mobilization of the ankle joint in the supine position. Afterwards, the Toe Touch test and the passive straight leg-raise test were re-assessed. Results: In the SMR group, the Toe Touch test results showed significant improvement (p<0.05). Left and right PSLR test results showed a significant increase (p<0.05). In the sham group, there was no significant difference between pre and post-test results. The SMR group showed a significant difference in the PSLR test and Toe Touch test compared to the sham group (p<0.05). Conclusions: The results of this study showed that SMR on the plantar fascia was immediately effective for improving the flexibility of the SBL of the lumbar spine and hamstring.

Clinical Experience of the Dynamic Stabilization System for the Degenerative Spine Disease

  • Lee, Soo-Eon;Park, Sung-Bae;Jahng, Tae-Ahn;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.221-226
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    • 2008
  • Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.