• The Journal of Korean Physical Therapy
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• 제29권4호
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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.

• Journal of Trauma and Injury
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• 제25권1호
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• pp.7-16
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• 2012

Purpose: Cervical dislocations with locked facets account for more than 50% of all cervical injuries. Thus, investigating a suitable management of cervical locked facets is important. This study examined factors of close reduction failure in traumatically locked facets of the subaxial cervical spine patients to determine suitable surgical management. Methods: We retrospectively analyzed of the case histories of 28 patients with unilateral/bilateral cervical locked facets from Nov. 2004 to Dec. 2010. Based on MRI evaluation of disc status at the injury level, we found unilateral dislocations in 9 cases, and bilateral dislocations in 19 cases, The patients were investigated for neurologic recovery, closed reduction rate, factors of the close reduction barrier, fusion rate and period, spinal alignment, and complications. Results: The closed reduction failed in 23(82%) patients. Disc herniation was an obstacle to closed reduction (p=0.015) and was more frequent in cases involving a unilateral dislocation (p=0.041). The pedicle or facet fracture was another factor, although some patients showed aggravation of neurologic symptoms, most patients had improved by the last follow up. The kyphotic angle were statistically significant (p=0.043). Sixs patient underwent anterior decompression/fusion, and 15 patients underwent circumferential fusion, and 7 patients underwent posterior fusion. All patients were fused at 3 months after surgery. The complications were 1 case of CSF leakage and 1 case of esphageal fistula, 1 case of infection. Conclusion: We recommend closed reduction be performed as soon as possible after injury to maximize the potential for neurological recovery. Patients fot whom closed reduction of the cervical locked facets have a higher incidence of anatomic obstacles to reduction, including facet fractures and disc herniation. Immediate direct open anterior reduction or circumferential fixation/fusion of locked cervical facets is recommended as a treatment of choice for traumatic locked cervical facet patients after closed reduction failure.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.255-258
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• 2005

Objective : Lumbar lordotic curve on L4 to S1 level is important in maintaining spinal sagittal alignment. Although there has been no definite report in lordotic value, loss of lumbar lordotic curve may lead to pathologic change especially in degenerative lumbar disease. This study examines the changes of lumbar lordotic curve after posterior lumbar interbody fusion with wedge shape cage. Methods : We studied 45patients who had undergone posterior lumbar interbody fusion with wedge shape cage and screw fixation due to degenerative lumbar disease. Preoperative and postoperative lateral radiographs were taken and one independent observer measured the change of lordotic curve and height of intervertebral space where cages were placed. Segmental lordotic curve angle was measured by Cobb method. Height of intervertebral space was measured by averaging the sum of anterior, posterior, and midpoint interbody distance. Clinical outcome was assessed on Prolo scale at 1month of postoperative period. Results : Nineteen paired wedge shape cages were placed on L4-5 level and 6 paired same cages were inserted on L5-S1 level. Among them, 18patients showed increased segmental lordotic curve angle. Mean increased segmental lordotic curve angle after placing the wedge shape cages was $1.96^{\circ}$. Mean increased disc height was 3.21mm. No cases showed retropulsion of cage. The clinical success rate on Prolo's scale was 92.0%. Conclusion : Posterior lumbar interbody fusion with wedge shape cage provides increased lordotic curve, increased height of intervertebral space, and satisfactory clinical outcome in a short-term period.

• 한국콘텐츠학회논문지
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• 제11권10호
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• pp.293-300
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• 2011

본 연구는 경추 및 흉추부 스트레칭과 근력강화 운동프로그램이 머리전방자세에 미치는 효과를 알아보고자 연구하였다. 머리전방자세를 갖고 있는 일반인 32명을 대상자로 자세교육과 운동프로그램을 적용한 실험군 16명과 자세교육만을 받은 대조군 16명을 대상으로 시행하였다. 두 개척추각(CVA:Craniovertebral Angle)과 두개회전각(CRA:Cranial Rotation Angle)을 X-ray로 검사하고, PACS(Picture Archiving and Communications System) ${\pi}view^{TM}$ 각도를 측정하였다. 연구결과 실험군은 두개척추각과 두개회전각이 통계적으로 유의한 차이가 있었다. 그러나 대조군은 두개회전각에서만 유의한 차이가 있었다. 또한, 실험 전 그룹 간 차이는 없었으나 실험 후 그룹 간 비교에서는 통계적으로 유의한 차이가 있었다. 이 연구에서는 경, 흉추부 스트레칭 및 근력강화 운동프로그램이 연구대상자들의 머리전방자세를 감소시키는 척추자세정렬을 향상시킬 수 있었다. 이 연구 결과들은 자세증진 치료들에 있어서 향후 발전되는 운동프로 그램을 위해 기초자료가 될 수 있다.

• Radiation Oncology Journal
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• 제36권2호
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• pp.122-128
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• 2018

Purpose: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and Methods: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction. Initial, pre-treatment, and post-treatment CBCTs were analyzed. Setup error (SE), pre-treatment residual error (preRE), post-treatment residual error (postRE), intrafraction motion before treatment (IM1), and intrafraction motion during treatment (IM2) were determined from 6 DoF manual rigid registration. Results: The three-dimensional (3D) magnitudes of translational uncertainties (mean ${\pm}$ 2 standard deviation) were $3.7{\pm}3.5mm$ (SE), $0.9{\pm}0.9mm$ (preRE), $1.2{\pm}1.5mm$ (postRE), $1.4{\pm}2.4mm$ (IM1), and $0.9{\pm}1.0mm$ (IM2), and average angular differences were $1.1^{\circ}{\pm}1.2^{\circ}$ (SE), $0.9^{\circ}{\pm}1.1^{\circ}$ (preRE), $0.9^{\circ}{\pm}1.1^{\circ}$ (postRE), $0.6^{\circ}{\pm}0.9^{\circ}$ (IM1), and $0.5^{\circ}{\pm}0.5^{\circ}$ (IM2). The 3D magnitude of SE, preRE, postRE, IM1, and IM2 exceeded 2 mm in 18, 0, 3, 3, and 1 patients, respectively. No association were found between all positional uncertainties and body mass index, pain score, and treatment location (p > 0.05, Mann-Whitney test). There was a tendency of intrafraction motion to increase with overall treatment time; however, the correlation was not statistically significant (p > 0.05, Spearman rank correlation test). Conclusion: In spine SBRT using TM immobilization, CBCT and 4 DoF alignment correction, a minimum residual translational uncertainty was 2 mm. Shortening overall treatment time and 6 DoF positional correction may further reduce positional uncertainties.

• 척추신경추나의학회지
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• 제9권1호
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• pp.1-14
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• 2014

Objective : The purpose of this study is to offer a new approach to diagnostic X-ray in perspective of Chuna manual medicine for clinical application. Methods : Characteristics of each malposition in X-ray were analyzed comprehensively, based on the listing system. By verifying these results, find out the methods of X-ray diagnosis according to the each malposition. Results : 1. Vertebral malposition can be explained by alignment and relative position of vertebral body in the X-ray. To obtain more accurate estimation of subluxation, features of other structures should be considered, such as spinous process, intervertebral foramen and disc space. 2. Pelvic malposition can be determined by relative location of anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) in the X-ray. Also other pelvic parameters should be utilized to make a diagnosis of sacral malposition. Conclusions : Diagnostic X-ray should be applied to many clinicians for reasonable Chuna manual medicine application. And further studies are needed to use the diagnostic X-ray in the perspective of Chuna manual medicine.

• Neurospine
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• 제15권4호
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• pp.362-367
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• 2018

Objective: To assess the efficacy of cervical open-door laminoplasty by hydroxyapatite implant insertion between the lamina and the lateral mass without suturing. Methods: All patients who underwent cervical open-door laminoplasty with C2/C7 undermining and insertion of hydroxyapatite implants from C3 to C6 were retrospectively evaluated for surgical time and neurological outcomes according to the Japanese Orthopaedic Association (JOA) score. To assess the alignment of the cervical spine and postoperative cervical pain, the C2-7 angle and a visual analogue scale score were used, respectively. Results: The population consisted of 102 women and 222 men ranging in age from 32 to 90 years. The average surgical time was 86 minutes. Fourteen of 1,296 hydroxyapatite implants were kept in place with sutures due to a weak restoration force of the hinge during surgery. No hydroxyapatite implant dislocation was detected on cervical computed tomography at 1 year after surgery. The average JOA score was $10.2{\pm}2.5$ before surgery and $14.6{\pm}2.8$ at 1 year after surgery. The average recovery rate was 61.8%. The average C2-7 angle at the neutral position was $7.1^{\circ}{\pm}6.2^{\circ}$ before surgery and $6.5^{\circ}{\pm}6.3^{\circ}$ at 1 year after surgery. Conclusion: This method enabled us to achieve minimal exposure of the lateral mass, prevention of lateral mass injury and dural injury, and a shorter surgical time while maintaining acceptable surgical outcomes. The idea that firm suture fixation is needed to prevent spacer deviation during cervical open-door laminoplasty may need to be revisited.

• 한국전문물리치료학회지
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• 제26권2호
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• pp.16-23
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• 2019

Background: High-heeled shoes can change spinal alignment and feet movement, which leads to muscle fatigue and discomfort in lumbopelvic region, legs, and feet while walking. Objects: This study aimed to identify the effects of different shoe heel heights on the walking velocity and electromyographic (EMG) activities of the lower leg muscles during short- and long-distance walking in young females. Methods: Fifteen young females were recruited in this study. The experiments were performed with the following two different shoe heel heights: 0 cm and 7 cm. All participants underwent an electromyographic procedure to measure the activities and fatigue levels of the tibialis anterior (TA), medial gastrocnemius (MG), rectus femoris (RF), and hamstring muscles with each heel height during both short- and long-distance walking. The walking velocities were measured using the short-distance (10-m walk) and long-distance (6-min walk) walking tests. Results: Significant interaction effects were found between heel height and walking distance conditions for the EMG activities and fatigue levels of TA and MG muscles, and walking velocity (p<.05). The walking velocity and activities of the TA, MG, and RF muscles appeared to be significantly different between the 0 cm and 7 cm heel heights during both short- and long-distance walking (p<.05). Significant difference in the fatigue level of the MG muscle were found between the 0 cm and 7 cm heel heights during long-distance walking. In addition, walking velocity and the fatigue level of the MG muscle at the 7 cm heel height revealed significant differences in the comparison of short- and long-distance walking (p<.05). Conclusion: These findings indicate that higher shoe heel height leads to a decrease in the walking velocity and an increase in the activity and fatigue level of the lower leg muscles, particularly during long-distance walking.

• 대한의용생체공학회:의공학회지
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• 제44권2호
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• pp.157-165
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• 2023

The purpose of this study was to evaluate the importance of developing slim seats with ergonomic design to improve seat comfort and expand the interior space. Two seats were used for the experiment: a sample seat designed based on hip shape and spinal alignment and a normal seat with a flat design without curves. Subjects sat in both the sample seat and a normal seat applied to the vehicle simulator and the experiment was conducted. The next part of the experiment was conducted in two different postures: a driving posture and a relaxed posture. The subjects filled out a comfort questionnaire immediately after sitting and after 30 minutes. The results showed that the comfort in the sample seat was found to be more comfortable than the normal seat. However, no significant difference was noted for the relaxation posture. Pressure distribution was also recorded immediately after sitting and after 30 minutes. In the case of pressure distribution, it was confirmed that the pressure in the sample seat was more evenly distributed in both the driving and relaxed postures than in the normal seat. The results showed that the ergonomically designed sample seat greatly improved seating comfort and pressure distribution compared to the normal seat, which is a general vehicle seat design.

• 한방재활의학과학회지
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• 제23권4호
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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.