• 재활복지공학회논문지
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• 제9권1호
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• pp.45-51
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• 2015

본 연구에서는 3차원 척추 안정화 운동이 고령자의 체간 근력 및 신체 구성 변화에 미치는 효과에 대해 검증하고자 하였다. 피험자는 건강한 65세 이상 고령자 40명(훈련군 20명, 대조군 20명)으로 구성하였다. 피험자는 실험 전 후 척추안정화 훈련 장치를 이용하여 8가지 방향에 대한 근력 평가를 수행하였다. 또한 체성분 분석기를 이용하여 신체 구성 변화에 대한 평가를 수행하였다. 훈련군은 척추 안정화 훈련 시스템에서 방향성 훈련(F, FOR, R, BOR, B, BOL, L, FOL)을 제공하였으며, 탄력 밴드 운동, 근력 강화 체조, 걷기 운동으로 구성된 복합운동을 30분간 수행하였다. 대조군은 척추 안정화 운동을 제외한 복합운동을 실시하였으며, 모든 훈련은 주 3회, 총 8주간 실시하였다. 그 결과 훈련군은 체간 근력이 실험 전 79.9점에서 8주 후 85.6점으로 유의하게 증가하는 결과를 보였으며, 신체구성에서도 체중 감소, 체지방 감소, BMI 지수 감소 등의 결과를 나타내었다. 반면, 대조군의 경우 체간 근력의 변화는 없었지만 골격근량 증가, 체지방 감소 등의 운동 효과를 나타내었다. 이러한 결과는 척추 안정화 운동이 고령자의 체간 근력 및 신체구성 발달을 유도하여 고령자의 비만 및 낙상 예방에 도움이 될 것으로 판단된다. 향후 이러한 데이터를 기반으로 척추 안정화 훈련기기와 복합운동을 조합하여 고령자들에게 효과적인 재활 운동 프로그램 개발에 응용될 수 있을 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제40권1호
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• pp.22-27
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• 2006

Objective : The purpose of this study is to investigate the clinical results of anterior and posterior stabilization by one stage posterolateral approach for the unstable fracture of thoracolumbar and lumbar spine. Methods : By posterolateral approach with curved skin incision, unilateral facet and pedicle were removed. Through this route, corpectomy was performed, and then this space was replaced with mesh cage filled up with autologous bone graft. Both side pedicle screw fixation was followed to upper and lower levels. Results : Six of seven patients of this study showed neurological improvement. The other one patient showed no neurological change. One patient had postoperative infection, another patient had postoperative kyphosis. The other patient had epidural hematoma on operation site after surgery. And all patinets on this study made to have spinal stability except one patient happened postoperative kyphosis. Conclusion : In the unstable fracture of thoracolumbar and lumbar spine, one stage anterior and posterior stabilization and fusion by posterolateral approach seems to be an effective procedure, if we have more care and supplementation.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2017년도 춘계 종합학술대회 논문집
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• pp.347-348
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• 2017

만성요통 환자 15명을 대상으로 4주간, 주 3회 3차원 척추안정화운동과 허리안정화운동을 실시한 후 3차원 척추안정화검사를 통하여 허리심부근력을 측정하고 Tetrax장비를 통하여 신체균형능력을 평가하였다. 단기간일지라도 3차원척추안정화운동을 통해 정확한 방법으로 운동을 실시하였더니 만성요통환자의 허리근력과 자세균형에 긍정적인 효과를 주었다.

• 한국전문물리치료학회지
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• 제7권4호
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• pp.47-55
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• 2000

요통은 산업화된 현대사회에서 흔히 발생하는 질환이다. 요통의 다양한 원인 중에서도 척추의 정상 가동범위를 넘은 불안정성이 요통의 한 원인으로 보고되고 있다. 이 문헌고찰의 목적은 요추 부위의 안정성을 부여하는 운동 프로그램 후 근육 기능의 강화, 통증의 감소를 보고한 논문들을 비교, 분석하는 것이다. 그리하여 요통의 한 원인인 척추의 안정성을 증가시켜 요추 부위의 통증을 감소시키고 기능을 향상시키는 운동 프로그램의 효과를 입증하는 것이다.

• 재활복지공학회논문지
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• 제11권3호
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• pp.119-126
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• 2017

임상현장에서 압력 바이오피드백 장치는 요통 환자들의 척추재활운동에 사용되고 있으나, 여러 가지 단점을 갖고 있다. 본 연구는 사용자에게 신체의 움직임과 균형을 센싱하고 모니터링하여 사용자에게 바이오피드백을 제공함으로써 척추재활운동시 실시간으로 정확한 운동방법과 자세를 제공하는 디지털화된 압력 바이오피드백 장치를 개발하고자 하였다. 그 후 사용성 평가를 진행하여 안전성, 수행성, 조작성, 만족성 등의 문제점을 파악하고 개선방향을 제시하고자 한다. 본 연구에 참여한 대상자는 총 33명으로 전문가 평가 집단 11명, 사용자 평가 집단 22명으로 실제 개발된 장비를 사용 후 5점 척도로 평가하였다. 사용자 집단에서는 안전성 3.59점, 조작성 4.38점, 만족성 4.49점으로 나타났으며, 전문가 집단에서는 안전성 2.86점, 조작성 3.91점, 수행성 4.28점으로 나타났다. 본 사용성 평가를 바탕으로 태블릿PC 거치대의 안정성 문제, 공기주입, 화면 표시 등의 문제점을 개선한다면 척추안정화 운동을 하면서 실시간 자신의 운동상태를 확인하여 정확한 운동과 기능 평가가 가능한 운동장치가 될 것이다.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.1-10
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• 2005

The purpose of this study was to verify the most effective spinal stabilization exercises program by comparing the activities of muscles contributing to spinal stabilization during four types of exercises using a sling and a mat. Twenty healthy males were recruited and each subjects performed four types of exercises. Exercise 1 was performed in a quadruped position with the subjects lifting the left arm and the opposite leg on the mat. Exercise 2 was performed in a prone position while holding a sling with the right hand and the left knee was fully extended while lifting the left arm and right leg. Exercise 3 was performed in quadruped position while holding a sling with one the right hand and lifting the opposite arm and leg. In exercise 4, subjects were instructed to maintain a balance push-up position while holding slings with both hands in 10 cm forward reaching with extended elbows. Electromyographic(EMG) activities were recorded from the multifidus, external oblique, internal oblique, abdominal rectus, and erector spinalis muscles during the exercises. The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary isometric contraction (MVIC) of each muscle. Repeated ANOVA and Bonferroni's tests were used to compare the differences in the muscle activity according to the types of exercise. The EMG amplitudes of all the muscles were significantly different according to the types of exercises (p<.05). The highest EMG activities of each muscle was as follow; multifidus was 73.38%MVIC in exercise 3, the erector spinalis was 40.03%MVIC in exercise 3, the external oblique was 135.88%MVIC in exercise 4, the internal oblique was 128.60%MVIC in exercise 4, and the rectus abdominalis was 95.24%MVIC in Exercise 4. The types of exercises showed a significant difference in composition rate of EMG amplitudes of each muscle (p<.05). EMG composition rate of the multifidus was high in exercise 1 and 3. However, EMG composition rates of the external oblique, internal oblique, and the rectus abdominals were high in exercise 2 and 4. These results showed differences in EMG activities of muscles contributing to trunk stabilization during different therapeutic exercises. Therefore, the type of exercise should be carefully selected to effectively strengthen a specific trunk stabilizer.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.206-210
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• 2005

Objective : Our aim is to evaluate the early changes of biologic markers such as white blood cell[WBC] count, erythrocyte sedimentation rate[ESR] and C-reactive protein[CRP] in early diagnosis of postoperative infection and to differentiate infection from inflammatory reaction in lumbar spine surgery. Methods : We reviewed 330patients who had undergone spinal operations between May 1999 and October 2001. For this study, the patients were classified into two groups, which include a group that underwent spinal decompressive surgery without instrumentation[SD], and the other group that underwent fusion surgery with spinal instrumentation[SI]. And each group was also subdivided into two groups respectively, one with infection and the other without infection. We retrospectively analyzed the WBC count, ESR and CRP preoperatively and postoperatively, according to their operation type and postoperative infection history. Results : Inflammatory indices were physiologically affected by instrumentation itself. But ESR and CRP elevations were more prolonged and sustained under infection. In SD patients without infection, ESR and CRP were stabilized 5 days after surgery. In SI patients without infection, CRP was stabilized about 7days after surgery, but ESR showed sustained and variously elevated. In both SD and SI groups, the stabilization of CRP was the most reliable behavior of surgery without infection. Conclusion : C-reactive protein is most sensitive parameter for postoperative spine infection. The knowledge of the inflammatory indices and their relatively uniform patterns with or without infection offers surgeons the ability to infer the state of surgical wound.

• 중환자간호학회지
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• 제14권1호
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• pp.28-39
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• 2021

Purpose : This study investigated the occurrence of postoperative ileus and its related factors in patients after spinal surgery. Methods : After a retrospective review of data from patients who underwent spinal surgery at a single hospital located in Busan from 2012 through 2016, a total of 253 patients were included. The subjects were divided into non-ileus and ileus groups. We compared patient-, surgery-, and postoperative hematological-related factors. Results : A total of 41 (16.2%) out of 253 patients experienced postoperative ileus. Data analysis revealed significant differences between the two groups in mean age (68.44 vs 60.50 years), occupation (9.8 vs 28.8%), cardiovascular comorbidity (63.4 vs 37.7%), approach of surgery (supine/prone: 29.3/70.7 vs 12.7/87.3%), duration of anesthesia (5.86 vs 4.43 hours), narcotic use (75.6 vs 56.6%), postoperative serum hemoglobin level (3 days: 10.81 vs 11.41 g/dL), postoperative serum protein (immediately/3 days: 5.30/5.43 vs 5.62/5.68 g/dL), postoperative albumin level (3 days: 3.17 vs 3.40 g/dL), postoperative C-reactive protein level (3 days: 11.44 vs 8.36 mg/dL), postoperative bed stabilization period (3.32 vs 2.50 days), and onset of bowel movement (2.59 vs 1.94 days). In multivariate logistic regression, age and time of anesthesia were independent risk factors of postoperative ileus. Conclusion : To detect ileus after spinal surgery early, nurse education is needed with intensive screening on advanced age, surgery-related factors, and postoperative hematological indices.

• 국제물리치료학회지
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• 제4권1호
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• pp.523-531
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• 2013

Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.

• 대한의용생체공학회:의공학회지
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• 제29권2호
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• pp.139-145
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• 2008

Many recent studies suggest that the posterior dynamic stabilization(PDS) can be a more physiologically-relevant alternative to the rigid fixation for the patients suffering from low back pain. However, its biomechanical effects or clinically proven efficacies still remain unknown. In this study, we evaluated kinematic behaviors of the lower lumbar spine with the PDS system and then compared to those of the rigid fixation system using finite element (FE) analysis. A validated FE model of intact lumbar spine(L2-L5) was developed. The implanted model was then constructed after modification from the intact to simulate two kinds of pedicle screw systems (PDS and the rigid fixation). Hybrid protocol was used to flex, extend, laterally bend and axially rotate the FE model. Results showed that the PDS systems are more flexible than rigid fixation systems, yet not flexible enough to preserve motion. PDS system allowed $16.2{\sim}42.2%$ more intersegmental rotation than the rigid fixation at the implanted level. One the other hand, at the adjacent level it allowed more range of motion ($2.0%{\sim}8.3%$) than the rigid fixation. The center of rotation of the PDS model remained closer to that of the intact spine. These results suggest that the PDS system could be able to prevent excessive motion at the adjacent levels and restore the spinal kinematics.