• Title/Summary/Keyword: Postural reduction

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Percutaneous Vertebroplasty Following Postural Reduction in Unstable Vertebra Plana; Is it a Contraindication?

  • Kim, Seok-Won;Lee, Seung-Meung;Shin, Ho;Kim, Hyun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.92-95
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    • 2006
  • Objective : Severe vertebral body collapse [vertebra plana] is considered a contraindication to vertebroplasty by most authors. The purpose of this study is to determine the efficacy of vertebroplasty in treating severe compression fracture patients with osteoporosis. Methods : 16 patients underwent 18 vertebroplasties following postural reduction for vertebra plana. The fractures were defined vertebrae that have collapsed to more than 75% of their original height. Imaging and clinical features were analyzed, including involved vertebrae level, vertebral height after postural reduction for 2 days, injected cement volume, clinical outcome and complications. Results : Involved veretebra were located from level T7 to L4. Vertebral body collapse averaged 79% [range $12{\sim}25%$] of the original height. After pillow reduction for 2 days, vertebral body height increased 35% of the original height [range $15{\sim}45%$]. The kyphotic wedge was $12^{\circ}$ before procedure and was decreased $7.0^{\circ}$ after vertebroplasty. The mean injected cement volume was 3.8ml [range $2.0{\sim}4.9ml$]. After the procedure, surgical outcome was excellent in 8 [50%] of 16 patients, good in 7 [42%] and unchanged in one [8%]. The mean pain score [VAS score] prior to vertebroplasty was 8.3 and it changed 3.2 after the procure. Cement leakage to the adjacent disc [5 cases] and paravertebral soft tissues [4 cases] developed but there were no major complications. Conclusion : We propose that vertebra plana due to osteoporosis is not a contraindication to vertebroplasty. Vertebroplasty following postural reduction for severe compression fracture is safe and effective treatment.

An Effect of Load and Genders on Postural Stability (취급자재의 무게와 성별이 균형 능력에 미치는 영향)

  • Yang, Byoung-Hak
    • Journal of the Korea Safety Management & Science
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    • v.12 no.3
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    • pp.101-106
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    • 2010
  • The purposes of this paper are to investigate an effect of weight of material and gender on postural stability and to introduce formulas for those. There were five levels of weights 0, 9, 18, 27 and 36 kg, and two levels of genders were conducted. Eight male and five female subjects participated in this experiment, ten tests were performed for each level of weights to measure the postural stability by using the stability platform. The effect of the genders and the load on the postural stability were statistically analysed by the two way ANOVA test and the regression analysis. The ANOVA test showed that the effect of weights was statistically significant on postural stability to the both male and female subjects. And the postural stability of female subjects was better than that of male subjects. A linear regression formula for the balancing time and the load and a formula for the reduction rate postural stability and the relative load were introduced by the regression analysis.

Bone Cement Augmentation of Short Segment Fixation for Unstable Burst Fracture in Severe Osteoporosis

  • Kim, Hyeun-Sung;Park, Sung-Keun;Joy, Hoon;Ryu, Jae-Kwang;Kim, Seok-Won;Ju, Chang-Il
    • Journal of Korean Neurosurgical Society
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    • v.44 no.1
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    • pp.8-14
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    • 2008
  • Objective : The purpose of this study was to determine the efficacy of short segment fixation following postural reduction for the re-expansion and stabilization of unstable burst fractures in patients with osteoporosis. Methods : Twenty patients underwent short segment fixation following postural reduction using a soft roll at the involved vertebra in cases of severely collapsed vertebrae of more than half their original height. All patients had unstable burst fracture with canal compromise, but their motor power was intact. The surgical procedure included postural reduction for 2 days and bone cement-augmented pedicle screw fixations at one level above, one level below and the fractured level itself. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period was 15 months. The mean pain score (visual analogue scale) prior to surgery was 8.1, which decreased to 2.8 at 7 days after surgery. The kyphotic angle improved significantly from $21.6{\pm}5.8^{\circ}$ before surgery to $5.2{\pm}3.7^{\circ}$ after surgery. The fraction of the height of the vertebra increased from 35% and 40% to 70% in the anterior and middle portion. There were no signs of hardware pull-out, cement leakage into the spinal canal or aggravation of kyphotic deformities. Conclusion : In the management of unstable burst fracture in patients with severe osteoporosis, short segment pedicle screw fixation with bone cement augmentation following postural reduction can be used to reduce the total levels of pedicle screw fixation and to correct kyphotic deformities.

Effects on Walking & Balance upon Improvement of Postural Control Therapy for Hemiplegic Patient (자세조절 증진이 편마비 환자의 보행과 균형에 미치는 영향 -증례 보고-)

  • Lee, Jin-Hwan;Min, Dong-Ki
    • PNF and Movement
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    • v.11 no.2
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    • pp.119-126
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    • 2013
  • Purpose : The neurologically impaired patients have sensory, motor, cognition, perception problems which cause reduction of body schema, balance control and postural control provoke disfunction. The purpose of this case report was to evaluate effects on gait&balance upon improvement of postural control for left hemiplegia. Methods : This study has performed single subject design from March to April 2013 for 6 weeks. The subject of this study was a 67years old female patient with left hemiplegia. Timed Up and Go (TUG) test and Functional Reach (FR) test were used as evaluation tool. The subject was treated 5 times a week for 30 minutes each. Results : The result is that the walking velocity was decreased, the ability of gait was improved than before the training. The length of FR was increased from 8.33cm to 22.67cm. Conclusion : According to the results, the treatment improves subject's ability of walking in this study.

Effects of Vibratory Stimulus on Postural Balance Control during Standing on a Stable and an Unstable Support (안정판과 불안정판에서 자세 균형 조절에 대한 진동자극의 영향)

  • Yu, Mi;Eun, Hey-In;Kim, Dong-Wook;Kwon, Tae-Kyu;Kim, Nam-Gyun
    • Journal of Biomedical Engineering Research
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    • v.28 no.5
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    • pp.647-656
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    • 2007
  • The purpose of this study was to analyze the effects of vibratory stimulus as somatosensory inputs on the postural control in human standing. To study these effects, the center of pressure(COP) was observed while subjects were standing on a stable and an unstable support with co-stimulated mechanical vibrations to flexor ankle muscles(tibialis anterior tendon, achilles tendon) and two plantar zones on both foot. The COP sway measurement was repeated twice in four conditions: (1) with visual cue and vibration, (2) without visual cue and vibration, (3) with visual cue and without vibration, (4) without visual cue and with vibration. The calculated parameters were the COP sway area and the distance, the median frequency and the spectral energy of COP sway in three intervals $0.1{\sim}0.3,\;0.3{\sim}1,\;1{\sim}3Hz$. The results showed that vibratory stimulus affect postural stability. The reduction rate of the COP sway with vibratory stimulus were higher on the unstable support because the effect of postural stability increases when afferent nervous flow is more activated by vibration on unstable support. If unclear visual or vibratory information is received, one type of information is compared with the other type of sensory information. Then the input balance between visual and vibratory information is corrected to maintain postural stability. These findings are important for the rehabilitation system of postural balance control and the use of vibratory information.

Effects of Transcutaneous Electrical Nerve Stimulation depending on Frequency and Intensity for Postural Sway during Sit to Stand with Stroke Patients

  • Byun, Dong-Uk;Shin, Won-Seob
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.136-142
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    • 2013
  • Purpose: The application of transcutaneous electrical nerve stimulation (TENS) is beneficial for joint movements, inhibition of spasticity, and the improvement of walking ability in patients with chronic hemiplegia. This study aimed to identify the effect of the application of TENS to the knee extensor on the affected side with respect to postural-sway distance and velocity during the sit-to stand movement. Methods: We included 19 patients with post-stroke hemiplegia in this study. They underwent measurements during the sit-to stand movement on a force plate with 5 different stimulation dosages applied over 7 s:No TENS, high-frequency and high intensity TENS, high-frequency and low intensity TENS, low-frequency and high intensity TENS, and low-frequency and low intensity TENS The 5 different condition were administered in random order. Results: The group that received TENS application exhibited a significant decrease in path length and average velocity of center of pressure (COP) displacement compared with the group that did not receive TENS application. TENS dosage at low frequency (3Hz) and high intensity yielded a significant decrease in path length, average velocity, mediolateral distance and anteroposterior distance of COP displacement (p<0.05). Conclusion: Our results demonstrated the effectiveness of the application of low-frequency TENS on STS performance. These findings provide useful information on the application of TENS for the reduction of postural sway during the sit-to-stand movement after stroke.

The Effect of Postural Correction and Subsequent Balloon Inflation in Deformity Correction of Acute Osteoporotic Vertebral Fractures

  • Liu, Hai-Xiao;Xu, Cong;Shang, Ping;Shen, Yue;Xu, Hua-Zi
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.337-342
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    • 2014
  • Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. Results : Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and $5.34^{\circ}$ compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by $8.32^{\circ}$ (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). Conclusion : In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.

Effects of Freezing of Gait and Visual Information on the Static Postural Control Ability in Patients with Parkinson's Disease

  • Kim, Jung Yee;Son, Min Ji;Kim, You Kyung;Lee, Meoung Gon;Kim, Jin Hee;Youm, Chang Hong
    • Korean Journal of Applied Biomechanics
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    • v.26 no.3
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    • pp.293-301
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    • 2016
  • Objective: The purpose of this study was to analyze the effects of freezing of gait and visual information on the static postural control ability in patients with Parkinson's Disease (PD) during the bipedal stance with feet together. Method: This study included a total of 36 patients with PD; the freezer group included 17 PD patients (age: $69.3{\pm}6.2yrs$, height: $159.6{\pm}9.0cm$, weight: $63.4{\pm}9.78kg$) and the nonfreezer group included 19 PD patients (age: $71.4{\pm}5.6yrs$, height: $155.8{\pm}7.1cm$, weight: $57.7{\pm}8.6kg$). Static postural control ability was analyzed using variables of center of pressure (COP) and dividing by mediolateral, anteroposterior, and integration factors during a bipedal stance with the eyes open and closed. Results: Freezers and nonfreezers showed increases in anteroposterior velocity, mediolateral velocity, averaged velocity, and mediolateral 95% edge frequency when visual information was blocked. Additionally, freezers had greater anteroposterior range, 95% confidence ellipse area, and COP anteroposterior mean position than nonfreezers. Conclusion: Freezers and nonfreezers showed a reduction in static postural control ability when visual information was blocked. Additionally, the results of this study found a significant difference in static postural control ability between freezers and nonfreezers with PD. In particular, anteroposterior range, 95% confidence ellipse area, and COP anteroposterior mean position might be used to distinguish between freezers and nonfreezers with PD.

Effect of Flexi-bar exercise on postural alignment and balance ability in juvenile soccer players (플렉시-바 운동이 유소년 축구선수의 자세정렬과 균형에 미치는 효과)

  • Um, Ki-Mai;Wang, Joong-San
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5296-5303
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    • 2015
  • This study aimed to analyze the effect of flexi-bar exercise on changes in postural alignment and balance of juvenile soccer players. The subjects were juveniles soccer players divided into exercise and control groups of 10 players each. The exercise group performed a flexi-bar exercise for 30 minutes a day three times weekly for eight weeks, and the differences in postural alignment and balance before and after the experiment and between study groups were analyzed. The measurements before the subjects exercised revealed overall asymmetric postural alignments and balance toward the right and rear sides. The study results showed that the exercise group had a statistically significant improvement in the height and angle of both shoulder, scapula, pelvis and hands(p<.05) after performing the exercise. Changes in balance showed that the exercise group had statistically significant reduction in changes in curve length(p<.05). The study verified that flexi-bar exercise can be effective for improving the postural alignment and balance of juvenile soccer players.

Short Segment Screw Fixation without Fusion for Unstable Thoracolumbar and Lumbar Burst Fracture : A Prospective Study on Selective Consecutive Patients

  • Kim, Hee-Yul;Kim, Hyeun-Sung;Kim, Seok-Won;Ju, Chang-Il;Lee, Sung-Myung;Park, Hyun-Jong
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.203-207
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    • 2012
  • Objective: The purpose of this prospective study was to evaluate the efficacy and safety of screw fixation without bone fusion for unstable thoracolumbar and lumbar burst fracture. Methods: Nine patients younger than 40 years underwent screw fixation without bone fusion, following postural reduction using a soft roll at the involved vertebra, in cases of burst fracture. Their motor power was intact in spite of severe canal compromise. The surgical procedure included postural reduction for 3 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants 12 months after the initial operation, due to possibility of implant failure. Imaging and clinical findings, including canal encroachment, vertebral height, clinical outcome, and complications were analyzed. Results: Prior to surgery, the mean pain score (visual analogue scale) was 8.2, which decreased to 2.2 at 12 months after screw fixation. None of the patients complained of worsening of pain during 6 months after implant removal. All patients were graded as having excellent or good outcomes at 6 months after implant removal. The proportion of canal compromise at the fractured level improved from 55% to 35% at 12 months after surgery. The mean preoperative vertebral height loss was 45.3%, which improved to 20.6% at 6 months after implant removal. There were no neurological deficits related to neural injury. The improved vertebral height and canal compromise were maintained at 6 months after implant removal. Conclusion: Short segment pedicle screw fixation, including fractured level itself, without bone fusion following postural reduction can be an effective and safe operative technique in the management of selected young patients suffering from unstable burst fracture.