• Title/Summary/Keyword: Posture alignment

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Effects of Manual Intervention and Self-Corrective Exercise Models of the General Coordinative Manipulation on Balance Restoration of Spine and Extremities Joints

  • Moon, Sang Eun;Kim, Mi Hwa
    • Journal of International Academy of Physical Therapy Research
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    • v.4 no.2
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    • pp.573-587
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    • 2013
  • The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

Surgical Decision for Elderly Spine Deformity Patient (노인 척추 변형 환자의 수술적 결정)

  • Kim, Yong-Chan;Juh, Hyung-Suk;Lee, Keunho
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.1-8
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    • 2019
  • Globally, the elderly population is increasing rapidly, which means that the number of deformity correction operations for elderly spine deformity patient has increased. On the other hand, for aged patients with deformity correction operation, preoperative considerations to reduce the complications and predict a good clinical outcome are not completely understood. First, medical comorbidity needs to be evaluated preoperatively with the Cumulative Illness Rating Scale for Geriatrics or the Charlson Comorbidity Index scores. Medical comorbidities are associated with the postoperative complication rate. Managing these comorbidities preoperatively decreases the complications after a spine deformity correction operation. Second, bone densitometry need to be checked for osteoporosis. Many surgical techniques have been introduced to prevent the complications associated with posterior instrumentation for osteoporosis patients. The preoperative use of an osteogenesis inducing agent - teriparatide was also reported to reduce the complication rate. Third, total body sagittal alignment need to be considered. Many elderly spine deformity patients accompanied degenerative changes and deformities at their lower extremities. In addition, a compensation mechanism induces the deformed posture of the lower extremities. Recently, some authors introduced a parameter including total body sagittal alignment, which can predict the clinical outcome better than previous parameters limited to the spine or pelvis. As a result, total body sagittal alignment needs to be considered for elderly spine deformity patients after a deformity correction operation. In conclusion, for elderly spine deformity patients, medical comorbidities and osteoporosis need to be evaluated and managed preoperatively to reduce the complication rate. In addition, total body sagittal alignment needs to be considered, which is associated with better clinical outcomes than the previous parameters limited to the spine or pelvis.

Research Trends of Abnormal Postures in Korean Literature -Based on Abnormal Spinal Alignment in the Sagittal Plane- (자세이상과 관련된 국내 연구동향 분석 -시상면상의 척추 정렬 이상을 중심으로-)

  • Park, Jung-Sik;Lim, Hyung-Ho;Song, Yun-Kyung;Ko, Youn-Seok;Lee, Jung-Han;Chung, Won-Suk;Shin, Byung-Cheul;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.117-128
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    • 2013
  • Objectives The purpose of this study is analyzing internal research trends of abnormal postures and providing problems of researches forward. Methods 6 Korean databases were searched for articles of abnormal postures, irrespective of publication year and 30 research were systematically reviewed. An analytical method such as descriptive statistics and an acutal number and percentage was used. Results We collected 30 studies. 16 studies were published within the last four years. 2012 saw 7 studies, the highest number of studies. Clinical research is the major research method. 26 studies were clinical research. The studies can be categorized according to the characteristic of the research content such as research of related factors or physical characteristics, research of treatment or programs, etc. 16 studies were about research of treatment or programs, the most number of studies. 11 studies were about research of related factors or physical characteristics, and 3 studies were about other issues. Conclusions Since the connection among postural abnormality, pain, and musculoskeletal system disorder has been raising, it is important to conduct a continued, methodical study.

Kinematic Analysis of Horse-Riding Posture According to Skill Levels during Rising Trot with JeJu-horse (제주마를 이용한 승마 경속보시 숙련도에 따른 기승자세의 운동학적 비교분석)

  • Oh, Woon-Yong;Ryew, Che-Cheong;Kim, Jin-Hyun;Hyun, Sung-Hyun
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.467-479
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    • 2009
  • The purpose of this study was to present the quantitative data which riders can utilize teaching field by comparison analysis of kinematics according to skill level of rider during 2 strides rising trot with the JeJu's-Horse. Participated subjects was consisted of total 10 riders(unskilled: n=5, skilled: n=5). The method of experiment & analysis was based on 3D cinematography. Variables were consisted of temporal, linear & angular kinematics by each event & phase. The skilled assigned more ratio of elapsed time in air than support phase, had the less range of motion in up-down direction and more consistent velocity in lateral & forward direction and performed periodic up-down movement with alignment in vertical direction according to elapsing of phases. The skilled more flexed at elbow and extended backwardly according to elapsing of phases, while more flexed forwardly at hip & knee and plantarflexion at ankle. The skilled postured backward extension but the unskilled do forward flexion. That is, It was considered that the unskilled continued more unstable posture than the skilled during 2 strides in rising trot.

Comparison of Trunk Strategy to Maintain Balance during the One-Leg Stance on a Medio-Lateral Ramp and an Anterior-Posterior Ramp

  • Lee, Sang-Yeol;Lee, Myoung-Hee
    • The Journal of Korean Physical Therapy
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    • v.29 no.4
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    • pp.223-226
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    • 2017
  • Purpose: This study examined two trunk strategies - medio-lateral ramp and anterior-posterior ram - and their effects on pelvis and trunk movements, providing basic material for safe ramp utilization. Methods: The present study included 20 asymptomatic males recruited from a local university. Participants were asked to stand with their feet shoulder-width apart. Their dorsal side faced the camera, and measurements were performed while standing in a neutral double stance, one leg stance, $15^{\circ}$ of medial and lateral ramp, and $15^{\circ}$ of anterior and posterior ramp. Participants were allowed to practice for 3 minutes, and each participant had a 30 seconds rest between the two ramp conditions. One-way repeated measures analysis of variance was used to determine the effects the ramp conditions on spinal alignment. In all analyses, p<0.05 was used to indicate statistical significance. Results: The trunk-inclination angle on the posterior ramp was significantly lower than that of the double stance position (p<0.05). The trunk imbalance angle was significantly higher on the medial ramp, than that on the double stance position (p<0.05). The pelvic position and pelvic torsion angles were significantly higher in the medial, lateral, and anterior ramp positions than that of the double stance position (p<0.05). The pelvic rotation angles on the medial, lateral, and anterior ramps were significantly lower than that of the double stance position (p<0.05). Conclusion: These findings suggest that when people are exposed to the same form of ramp for an extended period, posture modifications may be triggered.

Additional Surgical Method Aimed to Increase Distractive Force during Occipitocervical Stabilization : Technical Note

  • Antar, Veysel;Turk, Okan
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.277-281
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    • 2018
  • Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.

Immediate Effects of the Downhill Treadmill Walking Exercise on Thoracic Angle and Thoracic Extensor Muscle Activity in Subjects With Thoracic Kyphosis (내리막 경사로 트레드밀 걷기 훈련이 흉추 뒤굽음증의 흉추각도와 흉추기립근 활성도에 미치는 영향)

  • Lee, Jun-hyeok;Jeon, Hye-seon;Kim, Ji-hyun;Park, Joo-hee;Yoon, Hyeo-bin
    • Physical Therapy Korea
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    • v.26 no.2
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    • pp.1-7
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    • 2019
  • Background: In previous studies, changes in postural alignment were found when the slope was changed during walking. Downhill walking straightens the trunk by shifting the line of gravity backward. Objects: This study investigated the effect of the downhill treadmill walking exercise (DTWE) on thoracic angle and thoracic erector spinae (TES) activation in subjects with thoracic kyphosis. Methods: A total of 20 subjects with thoracic kyphosis were recruited for this study. All the subjects performed the DTWE for 30 minutes. A surface EMG and 3D motion capture system were used to measure TES activation and thoracic angle before and after the DTWE. Paired t-tests were used to confirm the effect of the DTWE (p<.05). Results: Both the thoracic angle and TES activation had significantly increased after the DTWE compared to the baseline (p<.05). An increase in the thoracic angle indicates a decrease in kyphosis. Conclusion: The DTWE is effective for thoracic kyphosis patients as it decreases their kyphotic posture and increases the TES activation. Future longitudinal studies are required to investigate the long-term effects of the DTWE.

The Immediate Effect of Medial Arch Support on Dynamic Knee Valgus During Stair Descent and Its Relationship With the Severity of Pronated Feet

  • Yoo, Hwa-ik;Jung, Sung-hoon;Lee, Do-eun;Ahn, Il-kyu;Kwon, Oh-yun
    • Physical Therapy Korea
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    • v.29 no.3
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    • pp.208-214
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    • 2022
  • Background: Pronated foot posture (PFP) contributes to excessive dynamic knee valgus (DKV). Although foot orthoses such as medial arch support (MAS) are widely and easily used in clinical practice and sports, few studies have investigated the effect of MAS on the improvement of DKV during stair descent in individuals with a PFP. Moreover, no studies reported the degree of improvement in DKV according to the severity of PFP when MAS was applied. Objects: This study aimed to examine the immediate effect of MAS on DKV during stair descent and determine the correlation between navicular drop distance and changes in DKV when MAS is applied. Methods: Twenty individuals with a PFP (15 males and five females) participated in this study. The navicular drop test was used to measure PFP severity. The frontal plane projection angle (FPPA) was calculated under two conditions, with and without MAS application, using 2-dimensional video analysis. Results: During stair descent, the FPPA with MAS (173.1° ± 4.7°) was significantly greater than that without MAS (164.8° ± 5.8°) (p < 0.05). There was also a significant correlation between the navicular drop distance and improvement in the FPPA when MAS was applied (r = 0.453, p = 0.045). Conclusion: MAS application can affect the decrease in DKV during stair descent. In addition, MAS application should be considered to improve the knee alignment for individuals with greater navicular drop distance.

Extending Plans of the Role of ROK Navy vis-'a-vis the Expansion of Maritime Security Threats (해양안보위협의 확산에 따른 한국해군의 역할 확대방안)

  • Kil, Byung-ok
    • Strategy21
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    • s.30
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    • pp.63-98
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    • 2012
  • Northeast Asia has a multi-layered security structure within which major economic and military powers both confront one another and cooperate at the same time. Major regional powers maintain mutually cooperative activities in the economic sphere while competing one another in order to secure a dominant position in the politico-military arena. The multifarious threats, posed by the North Korea's nuclear development, territorial disputes, and maritime demarcation line issues demonstrate that Northeast Asia suffers more from military conflicts and strifes than any other region in the world. Specifically, major maritime security threats include North Korea's nuclear proliferation and missile launching problems as well as military provocations nearby the Northern Limit Line(NLL) as witnessed in the Cheonan naval ship and Yeonpyong incidents. The ROK Navy has been supplementing its firm military readiness posture in consideration of North Korea's threats on the NLL. It has performed superb roles in defending the nation and establishing the Navy advanced and best picked. It also has been conducive to defend the nation from external military threats and invasion, secure the sea lanes of communications, and establish regional stability and world peace. In order to effectively cope with the strategic environment and future warfares, the ROK Navy needs to shift its military structure to one that is more information and technology intensive. In addition, it should consolidate the ROK-US alliance and extend military cooperative measures with neighboring countries in the Asia-Pacific region. Evolved steadily for the last 60 years, the ROK-US alliance format has contributed to peace and security on the Korean peninsula and in the Northeast Asian region. In conclusion, this manuscript contends that the ROK Navy should strive for the establishment of the following: (1) Construction of Jeju Naval Base; (2) Strategic Navy Equipped with War Deterrence Capabilities; (3) Korean-type of System of Systems; (4) Structure, Budget and Human Resources of the Naval Forces Similar to the Advanced Countries; and (5) Strategic Maritime Alliance and Alignment System as well as Domestic Governance Network for the Naval Families.

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Image Evaluation for Optimization of Radiological Protection in CBCT during Image-Guided Radiation Therapy (영상유도 방사선 치료 시 CBCT에서 방사선 방호최적화를 위한 영상평가)

  • Min-Ho Choi;Kyung-Wan Kim;Dong-Yeon Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.305-314
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    • 2023
  • With the development of medical technology and radiation treatment equipment, the frequency of high-precision radiation therapy such as intensity modulation radiation therapy has increased. Image-guided radiation therapy has become essential for radiation therapy in precise and complex treatment plans. In particular, with the introduction of imaging equipment for diagnosis in a linear accelerator, CBCT scanning became possible, which made it possible to calibrate and correct the patient's posture through 3D images. Although more precise reproduction of the patient's posture has become possible, the exposure dose delivered to the patient during the image acquisition process cannot be ignored. Radiation optimization is necessary in the field of radiation therapy, and efforts to reduce exposure are necessary. However, when acquiring 3D CBCT images by changing the imaging conditions to reduce exposure, there should be no image quality or artefacts that would make it impossible to align the patient's position. In this study, Rando phantom was used to scan and evaluate images for each shooting condition. The highest SNR was obtained at 100 kV 80 mA 25 ms F1 filter 180°. As the tube voltage and tube current increased, the noise decreased, and the bowtie filter showed the optimal effect at high tube current. Based on the actual scanned images, it was confirmed that patient alignment was possible under all imaging conditions, and that image-guided radiation therapy for patient alignment was possible under the condition of 70 kV 10 mA 20 ms F0 filter 180°, which showed the lowest SNR. In this study, image evaluation was conducted according to the imaging conditions, and low tube voltage, tube current, and small rotation angle scan are expected to be effective in reducing radiation exposure. Based on this, the patient's exposure dose should be kept as low as possible during CBCT imaging.