• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.108-113
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• 2014

Objective : Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods : Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results : A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions : Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.1-11
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• 2018

Background: The continuous co-contraction of the trunk muscles through trunk stabilization exercises is important to patients with lumbar spinal stenosis (LSS). However, intentional abdominal muscle contraction (IAMC) for trunk stabilization has been used only for specific training in the treatment room. Objects: The purpose of this study was to provide feedback to adults with LSS to enable IAMC during activities of daily living (ADLs). Methods: The participants with spinal stenosis were divided into an experimental group of 15 adults and a control group of 16 adults. Electromyographic signals were measured while the subjects kept their both hands held up at $90^{\circ}$. The measured muscles were the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES). Pelvic tilt was measured using a digital pelvic inclinometer. The degree of pain was measured using the visual analogue scale (VAS) and functional capacity was measured using the Korean version of the Oswestry disability index (KODI). Results: While the experimental group showed statistically significantly higher activities in the RA, EO, and IO after the intervention compared with the control group. Pelvic tilt was significantly decreased only in the experimental group. Both the experimental and control groups exhibited statistically significant declines in the VAS and KODI (p<.01). In terms of the levels of changes, the experimental group exhibited a statistically significant larger decline only in the VAS and the pelvic tilt when compared with the control group (p<.05). Conclusions: The subjects could stabilize their trunks, and relieve their pain and dysfunctions and reduce pelvic tilt by learning abdominal muscle contraction during ADLs. The combination of therapeutic exercises and IAMC may have greater effects on patients with LSS.

• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.43-49
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• 2015

Objective : $Dynesys^{(R)}$ is one of the pedicle-based dynamic lumbar stabilization systems and good clinical outcome has been reported. However, the cylindrical spacer between the heads of the screws undergoes deformation during assembly of the system. The pre-strain probably change the angle of instrumented spine with time and oblique-shaped spacer may reduce the pre-strain. We analyzed patients with single-level stabilization with $Dynesys^{(R)}$ and simulated oblique-shaped spacer with finite element (FE) model analysis. Methods : Consecutive 14 patients, who underwent surgery for single-level lumbar spinal stenosis and were followed-up more than 24 months (M : F=6 : 8; age, $58.7{\pm}8.0$ years), were analyzed. Lumbar lordosis and segmental angle at the index level were compared between preoperation and postoperative month 24. The von Mises stresses on the obliquely-cut spacer ($5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$, and $30^{\circ}$) were calculated under the compressive force of 400 N and 10 Nm of moment with validated FE model of the L4-5 spinal motion segment with segmental angle of $16^{\circ}$. Results : Lumbar lordosis was not changed, while segmental angle was changed significantly from $-8.1{\pm}7.2^{\circ}$ to $-5.9{\pm}6.7^{\circ}$ (p<0.01) at postoperative month 24. The maximum von Mises stresses were markedly decreased with increased angle of the spacer up to $20^{\circ}$. The stress on the spacer was uneven with cylindrical spacer but it became even with the $15^{\circ}$ oblique spacer. Conclusion : The decreased segmental lordosis may be partially related to the pre-strain of Dynesys. Further clinical and biomechanical studies are required for relevant use of the system.

• 한국정밀공학회지
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• 제30권3호
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• pp.331-339
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• 2013

The Interest in disease prevention and rehabilitation is increasing depending on increase of patients with spinal. This is being developed using the spine stabilization device is being studied. So far studies have only evaluated the effect on trunk stabilization exercises but analysis of human movement patterns for active movement and passive movement did not. We assessed the muscle activity of trunk and leg muscle during passive and active tilt mode on eight tilt directions at tilt angle of $30^{\circ}$ using 3-D dynamic postural balance training system. We performed experimental study on the muscular activities of trunk muscle about rectus abdominis, external obliques, latissimus dorsi, erector spinae, and leg muscle about rectus femoris, Biceps femoris, Tibialis Anterior, gastrocnemius. As a result, muscle activation was different depending on the direction of movement and pattern. The results indicate that various patterns of spinal stabilization exercise system could be applied to an effective training of chronic low back pain patients.

• 동의생리병리학회지
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• 제27권3호
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• pp.280-288
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• 2013

Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• Journal of Korean Neurosurgical Society
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• 제41권2호
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• pp.127-129
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• 2007

Two unusual cases of traumatic spondyloptosis of the cervical spine at the C7-T1 level are reported. One patient was treated with a single-stage combined anterior-posterior and anterior operation to achieve realignment of the cervical spondyloptosis, decompression of the spinal cord and keep of a three-column stabilization of the spine. The other patient was treated with conservative management that consisted of a rigid neck collar and pain control for two months. The patients were managed successfully and both had good neurological outcomes. We present here a summary of the clinical presentations, the surgical technique and results, and a review of the relevant literature.

• 한국응용과학기술학회지
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• 제37권3호
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• pp.496-508
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• 2020

This study reviews studies on the core stabilization of respiratory muscle training for the elderly health. Previous research data and presenting basic literature data suggest that respiratory activation is an important mechanism for core strengthening via exercise interventions for the elderly. The review found that first, the mechanism of improving the respiratory muscles weakened by aging to address the loss of core function due to old age sarcopenia among the elderly results entails promoting the autonomic nervous system by focusing on the respiratory muscle activation pattern, the core muscle sensation mobilized for body centering. Second, nerve roots, intraperitoneal pressure, and deep muscles in the trunk of the body can be promoted while controlling respiratory stimulation with cognitive feedback. Effortful inspiration increases the activation of respiratory assistive muscles and effortless exhalation can improve the core muscle mobilization by involving abdominal muscles. Third, through respiratory muscle training, the elderly can increase their awareness of spinal centering and improve the ability to control the deep core muscles that must be mobilized for core stabilization. In conclusion, respiratory muscle training to increase the utilization of the trunk muscles seems to be a useful core stabilization exercise for the elderly with chronic tension and joint degeneration.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2015년도 제46회 하계학술대회
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• pp.1425-1426
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• 2015

Core spine muscle are related are associated with trunk stability and play a main role for the prevention of low back pain. In this study, it was investigated the effect of spine stabilization exercise device on core spinal muscles using a musculoskeletal model The forward direction of the tilt mainly induced the activation of long and superficial back muscles and the backward affected the front muscles. It was shown that spine stabilization exercise device can induce significant core muscle exercise effect.

• 대한물리치료과학회지
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• 제7권2호
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• pp.415-425
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• 2000

It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.

• 로봇학회논문지
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• 제18권2호
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• pp.189-196
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• 2023

An abdominal brace is a recommended treatment for patients with lumbar spinal disorders. However, due to the nature of the static brace, it uniformly compresses the lumbar region, which can weaken the lumbar muscles or create a psychological dependence that worsens the condition of the spine when worn for an extended period of time. Due to these issues, doctors limit the wearing time when prescribing it to patients. In this paper, we propose a device that can dynamically provide abdominal pressure and support according to the lumbar motion. The proposed device is a wearable robot in the form of a brace, with actuators and a driving unit mounted on the brace. To enhance wearability and reduce the weight of the device, worm gears actuator and a multi-pulley mechanism were adopted. Based on the spinal motion of the wearer measured by the Inertia measurement unit sensors, the drives wire by driving pulley, which provide tension to the multi-pulley mechanism on both sides, dynamically tightening or loosening the device. Finally, the device can dynamically provide abdominal pressure and support. We describe the hardware and system configuration of the device and demonstrate its potential through basic control experiments.