• Physical Therapy Korea
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• v.26 no.3
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• pp.42-56
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• 2019

Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

• Physical Therapy Korea
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• v.29 no.2
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• pp.156-164
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• 2022

Background: Low back pain (LBP) is a representative disease, and LBP is characterized by muscle dysfunction that provides stability to the lumbar spine. This causes physical functional problems such as decreased posture control ability by reducing the muscular endurance and balance of the lumbar spine. Pelvic compression using instruments, which has been used during recent stabilization exercises, focuses on the anterior superior iliac spine of the pelvis and puts pressure on the sacroiliac joint during exercise, making the pelvis more symmetrical and stable. Currently, research has been actively conducted on the use of pelvic compression belts and non-elastic pelvic belts; however, few studies have conducted research on the application effect of pelvic compression using instruments. Objects: This study aimed to investigate whether there is a difference in trunk muscular endurance and dynamic and static balance ability levels by applying pelvic stabilization through a pelvic compression device between the LBP group and the non-LBP group. Methods: Thirty-nine subjects currently enrolled in Daejeon University were divided into 20 subjects with LBP group and 19 subjects without LBP (NLBP group), and the groups were compared with and without pelvic compression. The trunk muscular endurance test was performed with 4 movements, the dynamic balance test was performed using a Y-balance test, and the static balance test was performed using a Wii balance board. Results: There was a significant difference the LBP group and the NLBP group after pelvic compression was applied to all tests (p < 0.05). In the static and dynamic balance ability test after pelvic compression was applied, there was a significant difference in the LBP group than in the NLBP group (p < 0.05). Conclusion: These results show that pelvic compression using instruments has a positive effect on both those with and without LBP and that it has a greater impact on balance ability when applied to those with LBP.

• Korean Journal of Applied Biomechanics
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• v.25 no.2
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• pp.219-229
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• 2015

Objective : The purpose of this study was to analyze EMG according to surface type and elastic band usage during the pilates Superman movement. Method : The subjects were 10 female university students with a mean age of 27. The independent variables were surface type (yoga mat, air filled equipment, elastic mat) and elastic band usage. In order to measure muscle activity, the Noraxon(USA) was used. Eight muscles (upper trapezius, lower trapezius, thoracic spine, lumbar spine, gluteus maximus, gluteus medius, biceps femoris, semitendinosus) activation were analyzed. For the statistical analysis, MANOVA, independent t-test and Scheffe test for the post-hoc via SPSS 20.0 was used. Results : The left and right upper trapezius muscle activities were significantly reduced when using the elastic bands. In addition gluteus medius muscle activities significantly increased with the elastic band as well. Conclusion : According to the usage of the elastic band and the different types of surfaces, different muscle groups were recruited. Elastic bands were found to have more activation on the gluteus medius muscle meanwhile there was less activation on the upper trapezius during the pilates Superman movement.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.3
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• pp.81-86
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• 2015

PURPOSE: Bridge exercises are broadly used to develop trunk co-activation patterns that promote spine stability. This study was to analyze the trunk muscle activity during bridge exercise with various shoulder support surface(stable, sling, Swiss ball). METHODS: The subjects were 20 healthy subjects in their twenties. Subjects were performed bridge exercise on 4 different shoulder support surfaces using stable and labile instruments. 1) Bridge exercise on a stable surface. 2) Bridge exercise with their shoulder on a stable bench. 3) Bridge exercise with their shoulder on a sling. 4) Bridge exercise with their shoulder on a Swiss ball. Rectus abdominis, erector spinae, internal oblique, external oblique muscle activities were measured using electromyography. RESULTS: There were significant differences in RA, EO muscles between performing each of the 4 exercises(p<.05). RA and EO was recorded the highest activity during the bridge exercise with their shoulder on a sling. The lowest activity was recorded during conventional supine bridge on a stable surface. There were no differences found for the EO/RA and IO/RA ratio. The EO/RA and IO/RA ratio was the highest in the bridge exercise with their shoulders resting on a stable bench. CONCLUSION: These findings suggest that change of shoulder support surface during bridge exercise may be useful for enhancing the trunk stability.

• Physical Therapy Korea
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• v.28 no.3
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• pp.227-234
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• 2021

Background: The serratus posterior inferior (SPI) muscle originates from the spinous process of T11-L2 and inserts at the lower border of the 9-12th ribs. This muscle is involved in thoracolumbar rotation and stability. Several positions can be used to improve trunk stability; the quadruped position is a good position for easily maintaining a neutral spine. In particular, during one arm lifting, various muscles act to maintain a neutral trunk position, and the SPI is one of these muscles. If trunk stability is weakened, uncontrolled trunk rotation may occur at this time. Tape can be used to increase trunk stability. There have been no studies on the effect of taping applied to the SPI muscle on thoracolumbar junction (TLJ) stability. Objects: This study compared the TLJ rotation angle between three different conditions (without taping, transverse taping, and SPI muscle direction taping). Methods: Thirty subjects were recruited to the study (18 males and 12 females). The TLJ rotation angle was measured during one arm lifting in a quadruped position (ALQP). Two taping methods (transverse and SPI muscle direction taping) were applied, and the TLJ rotation angle was measured in the same movement. Results: SPI muscle direction taping significantly reduced TLJ rotation compared to that without taping (p < 0.001) and with transverse taping (p < 0.001). There was a significant difference in the TLJ rotation angle between transverse taping and SPI muscle direction taping (p < 0.017). Conclusion: SPI muscle direction taping reduces the TLJ rotation angle during ALQP. Therefore, SPI muscle direction taping is one method to improve TLJ stability and reduce uncontrolled TLJ rotation during ALQP.

• Journal of Biomedical Engineering Research
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• v.21 no.3 s.61
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• pp.295-301
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• 2000

It is known that among many factors, relative micromotion at bone/implant interfaces can hinder bone ingrowth into surface pores of an implant. Loading conditions, mechanical properties of spinal materials, friction coefficients at the interfaces and geometry of spinal segments would affect the relative micromotion and spinal stability. A finite clement model of the human lumbar spine segments (L4-L5) was constructed to investigate the mechanical sensitivity at the interfaces between bone and cage. Relative micromotion. Posterior axial displacement. bone stress, cage stress and friction force were predicted in changes of friction coefficients, loading conditions. bone density and age-related material/geometric properties of the spinal segments. Relative micromotion (slip distance in a static loading means relative micromotion in routine activity) at the interfaces increased significantly as the mechanical properties of cancellous bone, annulus fibers or/and ligaments decrease or/and as the friction coefficient at the interfaces decreases. The contact normal force at the interfaces decreased as cancellous bone density decreases or/and as the friction coefficient increases A significant increase of slip distance at anterior annulus occurred with an addition of torsion to compressive preload. Relative micromotion decreased with an increase of disc area. In conclusion. relative micromotion, stress response. Posterior axial displacement and contact normal force are sensitive to the friction coefficient of the interfaces, bone density, loading conditions and age-related geometric/material changes.

• Physical Therapy Korea
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• v.13 no.3
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• pp.102-110
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• 2006

To improve trunk stability, various exercise protocols were introduced into the clinical field. Trunk and lumbar stability exercises on unstable surfaces are especially recommended to improve lumbar stability. The purpose of this study was to compare abdominal oblique muscle activity during leg raising in hook-lying position among 3 different type of surface conditions (on floor (F), vestibular board (VB), and foam roll (FR)). Sixteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. Surface electromyography (EMG) activity was recorded from the internal and external oblique muscles of both sides. The normalized EMG activity was compared using a one-way repeated ANOVA. The results showed that the EMG activities of the internal oblique and external oblique of the lifted leg side during straight leg raising significantly increased under the FR condition when compared to the F condition. There was no significant difference of the EMG activity in abdominal oblique muscles between the VB and the FR conditions. The EMG activity of the internal oblique of supported leg side during the straight leg raising was significantly greater under the FR condition than the VB and F conditions (p<.05). The composition ratio of EMG activity of internal oblique muscles during straight leg raising was significantly increased under the FR condition. Therefore, straight leg raising exercise on foam roll in hook lying position could be beneficial to improve trunk and lumbar stability.

• Journal of Biomedical Engineering Research
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• v.38 no.1
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• pp.9-15
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• 2017

Recently, flexible cages have been introduced in an attempt to absorb and reduce the abnormal load transfer along the anterior parts of the spine. They are designed to be used with the pedicle screw systems to allow some mobility at the index level while containing ROM at the adjacent level. In this study, a finite element (FE) study was performed to assess biomechanical efficacies of the flexible cage when combined with pedicle screws with flexible rods. The post-operated models were constructed by modifying the L4-5 of a previously-validated 3-D FE model of the intact lumbar spine (L2-S1): (1) Type 1, flexible cage only; (2) Type 2, pedicle screws with flexible rods; (3) Type 3, interbody fusion cage plus pedicle screws with rigid rods; (4) Type 4, interbody fusion cage plus Type 2; (5) Type 5, Type 1 plus Type 2. Flexion/extension of 10 Nm with a compressive follower load of 400N was applied. As compared to the Type 3 (62~65%) and Type 4 (59~62%), Type 5 (53~55%) was able to limit the motion at the operated level effectively, despite moderate reduction at the adjacent level. It was also able to shift the load back to the anterior portions of the spine thus relieving excessively high posterior load transfer and to reduce stress on the endplate by absorbing the load with its flexible shape design features. The likelihood of component failure of flexble cage remained less than 30% regardless of loading conditions when combined with pedicle screws with flexible rods. Our study demonstrated that flexible cages when combined with posterior dynamic system may help reduce subsidence of cage and degeneration process at the adjacent levels while effectively providing stability at the operated level.

• Journal of Acupuncture Research
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• v.17 no.2
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• pp.153-168
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• 2000

Introduction : In spite of the use of Bee Venom aqua-acupuncture in the clinics, the scientific evaluation on effects is not enough. Bee Venom aqua-acupuncture is used according to the stimulation of acupuncture point and the chemical effects of Bee Venom. The aims of this study is to investigate the analgegic effects of the Bee Venom aqua-acupuncture, through the change of writhing reflex and the change of c-fos in secondary neurons in the spinal cord. Materials and Methods : Pain animal model was used acetic acid method. The changes of writhing reflex of the mice which were derived pain by injecting acetic acid into the abdomen, after stimulating Bee Venom aqua-acupuncture on Chungwan(CV12) were measured. We used Fos immunohistochemical technique to study the neuronal activity in the spinal cord. Results : 1. Expression of c-fos in superficial dorsal horn(SDH), nucleus proprius(NP) and neck of dorsal hom(N) on 6~9th thoracic spine decreased significantly at $2.5{\times}10-4$g/kg Bee Venom aqua-acupuncture, compared with saline-acetic acid group. 2. The numeral change of Fos-LI neurons on the NP, N, and ventral gray(V) on 6-9th thoracic spine, SDH on 9-11th thoracic spine, and SDH and V on 11~13th thoracic spine decreased significantly at Chungwan(CV12) Bee Venom aqua-acupuncture, compared with saline-acetic acid group. 3. The correlation between the numbers of writhing refleax and Fos-LI neurons in T6-13 segment was statistically statistically significant at Chungwan(CV12) Bee Venom aqua-acupuncture. Conclusion : This study shows that the Bee Venom aqua-acupuncture on Chungwan(CV12) decreases the numbers of Fos-LI neurons. As the analgegic effects of Bee Venom aqua-acupuncture is recognized. Bee Venom aqua-acupuncture treatment is expected for pain modulation. In order to use it in many ways, more researches are needed for the dose and stability of Bee Venom aqua-acupuncture.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.680-688
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• 2018

Objective : To mitigate the risk of iatrogenic instability, new posterior decompression techniques able to preserve musculoskeletal structures have been introduced but never extensively investigated from a biomechanical point of view. This study was aimed to investigate the impact on spinal flexibility caused by a unilateral laminotomy for bilateral decompression, in comparison to the intact condition and a laminectomy with preservation of a bony bridge at the vertebral arch. Secondary aims were to investigate the biomechanical effects of two-level decompression and the quantification of the restoration of stability after posterior fixation. Methods : A universal spine tester was used to measure the flexibility of six L2-L5 human spine specimens in intact conditions and after decompression and fixation surgeries. An incremental damage protocol was applied : 1) unilateral laminotomy for bilateral decompression at L3-L4; 2) on three specimens, the unilateral laminotomy was extended to L4-L5; 3) laminectomy with preservation of a bony bridge at the vertebral arch (at L3-L4 in the first three specimens and at L4-L5 in the rest); and 4) pedicle screw fixation at the involved levels. Results : Unilateral laminotomy for bilateral decompression had a minor influence on the lumbar flexibility. In flexion-extension, the median range of motion increased by 8%. The bone-preserving laminectomy did not cause major changes in spinal flexibility. Two-level decompression approximately induced a twofold destabilization compared to the single-level treatment, with greater effect on the lower level. Posterior fixation reduced the flexibility to values lower than in the intact conditions in all cases. Conclusion : In vitro testing of human lumbar specimens revealed that unilateral laminotomy for bilateral decompression and bone-preserving laminectomy induced a minor destabilization at the operated level. In absence of other pathological factors (e.g., clinical instability, spondylolisthesis), both techniques appear to be safe from a biomechanical point of view.